Alignment Healthcare jobs - 241 jobs

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. ***MUST HAVE CALIFORNIA LICENSE*** ***MUST HAVE UTILIZATION MANAGEMENT EXPERIENCE*** Utilization Management Physician Advisor works with Senior Medical Officers, Regional Medical Officers, Extensivists, the Healthcare Services Team (Case managers, Social Workers, Utilization Managers) to develop and implement methods to optimize use of Institutional and Outpatient services for all patients while also ensuring the quality of care provided. Through remote access to our web-based Portal, physician advisors will complete clinical reviews for medical necessity, treatment appropriateness and compliance. GENERAL DUTIES/RESPONSIBILITIES: Perform medical necessity utilization reviews primarily for inpatient and post-acute cases with some outpatient / pre-service reviews as needed in accordance with UM guidelines Lead concurrent review activities, including rounds, peer-to-peers, and utilization management strategies to improve clinical and efficiency outcomes Serve as a clinical leader and educator for the nursing / care management team Process claims reviews, appeals, and second-level reviews as needed in compliance with Medicare (NCD, LCD), internal, and third-party guidelines (e.g., MCG) for Inpatient, Outpatient, Skilled Facilities Level of Care and Pharmacy. Acts as a liaison between the medical staff, utilization review team, and 3rd parties to effectively promote clinically necessary and efficient utilization of care Serves as a Physician member of the utilization review team. Work with Interdisciplinary Teams to help manage complex or high risk cases Contributes to development of clinical strategies to improve member outcomes, efficiency metrics, and quality outcomes Duties may include serving on committees as needed, such as quality, utilization management, credentialing, etc Other duties as may be assigned to the medical director. Supervisory Responsibilities: Oversees assigned staff, if any. Responsibilities may include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees. Experience: • Required: Minimum of 3 years of experience in hospital-wide or skilled nursing facility position involving clinical care, quality management, utilization / case management, or medical staff governance required • Preferred: Experience as a Physician Advisor or Medical Director a plus Education: Required: Completion of medical school and specialty residency (preferably in internal medicine). Preferred: Board-certification Specialized Skills: • Required: Utilization Management Experience Ability to build rapport with medical staff and management leadership to obtain necessary approvals of new strategies for utilization management. Knowledge of current medical literature, research methodology, healthcare delivery systems, healthcare financial/reimbursement issues, and medical staff organizations. Dedication to the delivery of high-quality, cost-effective, efficient patient care services Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Licensure: • Required: California License, Applicants must have current, non-restricted licensure as required for clinical practice in the state of California. Work Environment: This is a remote position. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to talk or hear. 2 The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 3 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.

Responsibilities include but not limited to provide Desktop, Software and Network Support services remotely and on-site. The role requires strong technical skills with an emphasis on delivering superior customer service within our SLAs. In addition, the analyst will participate in projects such as PC refresh, and other projects based on business needs. This position reports to the Help Desk Manager. JOB DUTIES: Provides excellent customer service at all times to internal customers in a business, medical and dental environment Provides remote and on-site technical support Create incident/request tickets, prioritize, update and close tickets per SLAs Setup and configuration of new computers, software installation, updates and upgrades Setup and configuration of mobile devices Troubleshoot network issues Setup and troubleshoot printer, copier, scanner and fax issues Able to resolve technical issues independently and work with minimal supervision Interfaces with multiple departments to solve problems and improve process quality. Follows internal documentation and updates documentation as necessary. Updates software inventory as needed. Participates in a rotational after-hours on-call support Will be required to travel to different locations to support end-users if issue(s) cannot be resolved remotely Work with other IT departments and third-party vendors to resolve technical issues, and may serve as the primary liaison between internal IT teams and vendors Participates in special projects as assigned Qualifications JOB QUALIFICATIONS: 3 plus years of relevant desktop support experience or equivalent combination of education and work experience Strong problem and troubleshooting skills, excellent customer service skills, including professional phone and email interactions Able to work under pressure in a positive, friendly and professional manner Very good understanding of desktop and network administration fundamentals, Windows installations/upgrades, and problem solving analytical skills Vehicle transportation and able to lift 25 lbs. is required

Data Analyst External Description: Analyst - Corporate Finance, Corporate Strategy or Network Strategy We are actively recruiting Strategy and Financial Analysts to join our Corporate Finance, Corporate Strategy and Network Strategy teams. The teams are responsible for delivering analytic and strategic business insight to executives on core elements of the company's long-term strategy, as well as the shorter operational needs from core business functions. We are looking for innovative and creative individuals that have a desire to challenge paradigms while working as thought partners with executives throughout the company. The analyst will work with a team of highly motivated individuals with consulting, banking and public policy experience and is expected to effectively manage individual work streams and communicate analyses effectively within the team and with senior executives. Responsibilities Spearhead special projects, structure the work, manage the process, drive the right set of analyses, and present the answer to senior executives through a compelling storyline Aptitude for critical thinking in complex situations, ability to synthesize ambiguous data into concrete results Ability to drive multiple projects forward simultaneously; willing to stretch “up” and “down” in responsibilities Utilize working knowledge of financial statements in thoughtful financial analyses Requirements / Qualifications Bachelor's Degree with analytical and financially related coursework Complete proficiency in Microsoft Excel and PowerPoint VBA, SQL, and/or other programming skills highly desirable Demonstrated ability to be part of a fun, yet hard working team Experience with financial analysis, processes and terminology Ability to work efficiently and effectively with teammates 11+ hours / day Willingness to travel 10% - 30% of the time Language Skills Fluent in the written and verbal skills necessary to successfully perform the essential functions, duties, and responsibilities of the position Vision Requirements Vision adequate to perform essential duties and responsibilities of position Physical Demands Physical requirements can vary. These must be reviewed with management. However, in general, the position requires the following physical activities: Ability to lift minimum of 2 pounds to a maximum of 15 pounds unassisted; able to sit for extended periods of time with some standing, stooping, walking, stretching, reaching, lifting; moderate range of body motions Ability to use computer and all peripherals for extended periods of time City: Remote - CA State: California Location City: Remote - CA Schedule: Full Time Location State: California Community / Marketing Title: Data Analyst Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

What is PerfectServe? PerfectServe offers Best in KLAS assets in three categories: clinical communications, scheduling, and patient engagement solutions. We have seen an 88% growth rate over the past three years and need strong team members to help us continue to grow! PerfectServe's mission is to accelerate speed to care by optimizing provider schedules and dynamically routing messages to the right person at the right time in any care setting; advancing patient care and clinical workflows. By joining PerfectServe, you will have the unique opportunity to come alongside us as we further our vision of putting all of these solutions together to provide optimal patient outcomes and faster patient care interventions. By improving speed to care and cross-continuum communication, we save lives, reduce length of stay, minimize re-admissions, and bring joy back to caregivers. We have an incredible portfolio of customers, with new ones recognizing the value of our solutions and joining the PerfectServe family every day. As part of the Product Management team, the Product Manager (PM) is: A Strategic Visionary: responsible for the overall product strategy and vision for a single product vertical. You focus on the "why" behind the product, ensuring it aligns with business goals and market needs. Market and Customer Focused: conducting market research, identifying user needs, and defining the product's target audience. You often engage with prospects and customers directly. You are the voice of the customer and the market. Owner of the Product Roadmap: creating and maintaining the product roadmap, outlining planned initiatives over time. A Cross-Functional Leader: working closely with various departments (marketing, sales, support) to ensure the product meets business objectives and customer expectations. What You'll Do Provide vision and direction of the product from a patient and user-centered perspective to internal and external stakeholders. Assess new initiatives for strategic, product, and market fit, return on investment, and RICE priority. This includes developing a business case, documenting product requirements, conducting user interviews, reviewing application metrics, and surveying customers to collect supporting evidence. Refine initiatives for estimation by the development team collaboratively with UX designers, and architects. Set the next quarter's priorities, respond to changes in customer needs, and identify dependencies collaboratively with the senior leadership team (SLT) and single technology owners (STOs). Plan, communicate, and maintain a 3-year customer facing roadmap, working cross functionally with various departments. Quarterly plan the next program increment (PI) partnered with PerfectServe's engineering team. Establish, maintain, and report on product, product management, and roadmap delivery KPIs. Consult with Product Owners on customer release notes. Consult with the sales and success organizations as product experts, including joining strategic meetings, supporting the RFP process, and updating competitor battle cards. Requirements Bachelor's degree or equivalent work experience in a related field. At least 3+ years (or 5+ years for Senior PM) leading end-to-end product management on both SaaS and mobile platforms. Experience in process improvement. Iterating and advancing Agile maturity, defining customer discovery process and post-launch/go-to-market planning. The ability to communicate effectively with technical and non-technical teams. Strong orientation toward data and evidence. Willingness to question the status quo. Demonstrates experience balancing conflicting priorities and making decisions despite ambiguity. Ability to collaborate, lead through influence without authority, and foster teamwork (ideally in a remote-work environment). Proficient in capacity management and/or project management. Effective in technical or formal writing for varying audiences and levels of technical expertise. Beneficial Skills and Qualifications Domain knowledge in Clinical Communications and Collaboration, Clinical Mobility, Clinical Workflows, Patient and Family Communications, Hospital Call Centers, Afterhours Answering Services, and/or Provider Scheduling is a plus Experience using Jira, Confluence, Pendo, Visio, V0, Copilot is a plus Experience with Scaled Agile Framework (SAFe) is a plus Scrum Alliance Certified Scrum Master, or higher professional certification Scrum Alliance Certified Product Manager, or higher professional certification Graduate Degree (MBA, or MSc) Technical familiarity with RESTful API architecture, operations Technical familiarity with HTML, Angular, React or other front end web development languages Environment, Physical & Other Requirements This position requires interaction with people and technology while either standing or sitting. Most customer meetings are to be conducted with camera enabled. To best service our customers on the phone, face-to-face, or on the computer, all employees must be able to communicate with or without reasonable accommodation. This position requires up to 10% onsite travel to facilitate product management activities (customer interviews, work studies, and requirements gathering), and support sales and success teams. While performing the duties of this job, the employee must be able to sit for extended periods of time (position is primarily sedentary), must have acute hearing ability, must be able to speak English and must have the ability to perform repetitive hand motions. PerfectServe is committed to compliance with its obligations under all applicable state and federal laws prohibiting employment discrimination. In keeping with this commitment, it attempts to reasonably accommodate applicants and employees in accordance with the requirements of the disability discrimination laws. It also invites individuals with disabilities to participate in a good faith, interactive process to identify reasonable accommodations that can be made without imposing an undue hardship. PerfectServe, Inc. is an Equal Opportunity Employer -----M/F/D/V. Why Join PerfectServe? At PerfectServe, we are transforming healthcare communication and collaboration to help clinicians deliver better care. You'll work with a dedicated and mission-driven team in an environment that values growth, transparency, and innovation. **Please do not use AI tools to generate your application materials. We value authentic, personal communication and want to understand your unique voice and perspective.** We offer a salary range of $70,000-150,000 per year, with compensation tailored to your background, strengths, and potential to grow within the team. The salary range listed for this role reflects our commitment to pay transparency and is based on market data, internal equity, and the scope of responsibilities. compensation will be determined by a combination of factors, including the candidate's experience, skills, and the specific team or product area they support. We regularly review compensation across the company to ensure fairness and consistency. If you are a current employee and have questions about how your compensation aligns with our ranges, we encourage you to speak with your manager or People Operations. Benefits: Remote first work environment Health, Dental, Vision, Life and Disability Insurance options available day one. 401K - with match and immediately vested. 17 company holidays, 2 floating holidays plus competitive paid time off policy Internal Advancement Opportunities PerfectServe offers unified healthcare communication solutions to help physicians, nurses, and care team members provide exceptional patient care. PerfectServe's cloud-based solutions enhance patient safety and reduce provider burnout by automating workflows, speeding time to treatment, optimizing shift schedules, empowering nurse mobility, and engaging patients in their own care.

The SHP Manager provides leadership and oversight for case management staff delivering housing retention and supportive services to residents living in permanent supportive housing (PSH). This position ensures that services align with principles of Housing First, emphasizing client choice, harm reduction, and low-barrier access to housing and supportive services. The SHP Manager will supervise, train, and support a team of case managers; develop workflows, policies, and procedures; coordinate purchasing of equipment and supplies; lead case conferences; coordinate data entry, collection, and reporting; and collaborate closely with property management, resident services, and community partners to promote housing stability and overall well-being for clients. This is a grant funded, full time, 40 hours/week, benefit eligible position at our Oakland site in-person. LifeLong Medical Care is a multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. Benefits Compensation: $80,000 - $90,000/annunally. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including ten paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan. Responsibilities Staff Supervision & Development Recruit, hire, onboard, train, and supervise case managers and support staff Provide regular individual and group supervision, performance feedback, annual evaluations, and corrective or disciplinary action as necessary Foster professional growth through coaching, mentoring, and ongoing professional development opportunities Model trauma-informed, culturally responsive, and client-centered approaches in supervision and service delivery Identify training needs and collaborate with leadership to develop professional development or training opportunities for staff Program Oversight & Service Coordination Oversee the client-case manager lifecycle at all assigned sites that includes outreach, intake, enrollment, ongoing engagement, transitions, and program exit Ensure case management services reflect Housing First principles and support long-term housing stability Lead regular case conferences and multidisciplinary team meetings to review client progress and care plans Collaborate with behavioral health professionals assigned to the program to provide timely follow up to case managers regarding client behavioral concerns Attend and participate in housing stability meetings with funders, developers, property managers, service coordinators, and other partner agencies Coordinate and manage purchasing and equipment to support case management teams at assigned sites Collaborate with property management and resident services staff to address lease compliance issues, behavioral concerns, and community-building activities, balancing client rights with building safety Develop and implement program workflows, policies, and procedures that align with contractual, regulatory, and best practice standards Ensure effective communication and collaboration across internal teams and external partners Data, Reporting, & Compliance Oversee program data entry, documentation, and support reporting in compliance with funding and organizational requirements Monitor data quality, client outcomes, and program/staff performance metrics Prepare and submit reports for internal leadership, funders, and community stakeholders as needed Support staff with accurate and timely entry of service notes, assessments, and care plans Leadership & Continuous Improvement Develop and maintain relationships with outside agencies and community resources to promote program referrals and housing retention outcomes Serve as key liaison between supportive housing staff, property management, residents services, and other community partners Represent program in community meetings, coalitions, and trainings Identify opportunities for program improvement and innovation; lead implementation of new initiatives to strengthen the quality of case management services Respond to crises as needed, supporting staff with de-escalation, safety planning, and coordination of emergency services Support staff wellness by connecting them to internal resources such as Employee Assistance, benefits assistance, and/or other community resources as appropriate Uphold agency policies, ethical standards, and a commitment to equity, inclusion, and anti-racist practices in all aspects of the work Perform other duties as assigned by leadership Qualifications Job Requirements High school diploma or GED Minimum of 3 years of experience providing community-based support services for people experiencing homelessness or other special needs populations, especially those with mental health and substance use issues At least 1 year of team supervision and management experience Knowledge of Housing First, harm reduction, trauma-informed care, and evidence-based housing retention practices Strong supervisory skills, including recruitment, training, coaching, evaluation, and performance management Experience collaborating with property management, service providers, and multidisciplinary teams Proficiency with data systems (HMIS, EHR, or similar) and Microsoft Office Suite Excellent organizational, communication, and problem-solving skills Access to reliable transportation with current license and insurance Job Preferences Bachelor's degree in a related field (Psychology, Public Health, Social Work, Human Services, etc.) Lived experience of homelessness, incarceration, foster care, mental health services, substance use services or addiction, or as a close family member of someone who has this experience

LifeLong Medical Care has an exciting opportunity for a Care Coordinator at our Family Medical Residency Program in Richmond, California. The Care Coordinator will provide short term resource coordination and occasional longer term case management to patients in a busy primary care clinic serving a diverse and vulnerable population. This is a full time, benefit eligible position. Bilingual English/Spanish a must. This position is represented by SEIU-UHW. Salaries and benefits are set by a collective bargaining agreement (CBA), and an employee in this position must remain a member in good standing of SEIU-UHW, as defined in the CBA. LifeLong Medical Care is a large, multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. Benefits Compensation: $22 - $23/hour. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including nine paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan. Responsibilities Clinical: Direct Service * Assesses patients' psychosocial needs, assists in developing a patient-centered plan of care, and arranges for service delivery as needed. Meets with clients in clinic or community as safe and appropriate. Documents visits appropriately in EHR. * Develops relationships with community agencies and service providers and links clients to these services as needed. Coordinates with behavioral health team to act as an advocate for the client and liaison with outside agencies. * Assist and support patients in following through with medical care plans (e.g., attending specialist visits, obtaining labs or imaging, etc.) Communicate with providers and RN (Registered Nurse) team regarding outcomes. * Provides care coordination services, including referrals to community resources, advocacy for school-based interventions (IEP, 504 Plans, school-based counseling), coordination with medical and mental health providers, troubleshooting around insurance, medication, or transportation issues. Areas of assistance include Legal aid Paratransit and other Transportation programs Applications for financial benefits (SSI, SDI, GA, etc.) * Supportive housing services (Section-8, HUD (Housing and Urban Development), etc.) * Perform ongoing assessment of food insecurity and link patients to Jenkins-based and community-based resources for nutrition support (meals on wheels, WIC (Women with Infants and Children), Wellness Center, etc.). * In consultation with medical providers, provide ongoing assessments of in-home support (IHSS (InHome Supportive Services), Home Health, etc.). * Patient medication compliance and need for additional support (i.e., bubble packs). * Support medical team and families with discussions around end-of-life care and documentation (DNR/DNI, POLST, etc.) * Provides some clinical case management to individual clients. * Refers patients to eligibility team for assistance with insurance and other entitlement programs (Medi-Cal, Contra Costa CARES, CalFresh, etc.) Clinical: Team Participation * Participates constructively in both behavioral health team and interdisciplinary team to address the clinical and psychosocial needs of individual clients. * Be available for in-person warm-hand-offs for on-site consultation with patients. * Attends staff clinical team meetings. * Collaborates professionally with interdisciplinary team members and partners including other Behavioral Health providers, Patient Advocates, Primary Care Providers, Community Health Workers, Medical Assistants, and office support staff. * Advances the integration of Behavioral Health and Medical approaches to patient care through constructive and respectful partnerships. * Participates in agency and/or grant driven directives and outcomes. Qualifications * Patient-Centered approach to working with vulnerable communities. * Strong organizational, administrative, and problem-solving skills, and ability to be flexible and adaptive to change while maintaining a positive attitude. * Ability to prioritize tasks, work under pressure and complete assignment in a timely manner. * Ability to effectively present information to others, including other employees, community partners and vendors. * Ability to seek direction/approval on essential matters, yet work independently with little onsite supervision, using professional judgment and diplomacy. * Work in a team-oriented environment with several professionals with different work styles and support needs. * Excellent interpersonal, verbal, and written skills and ability to effectively work with people from diverse backgrounds and be culturally sensitive. * Conduct oneself in external settings in a way that reflects positively on LifeLong Medical Care as an organization of professional, confident, and sensitive staff. * Ability to see how one's work intersects with that of other departments of LifeLong Medical Care and that of other partner organizations. * Make appropriate use of knowledge/ expertise/connections of other staff. * Be creative and mature with a "can do," proactive attitude and an ability to continuously "scan" the environment, identifying and taking advantage of opportunities for improvement. * Commitment to working directly with low-income persons from diverse backgrounds, in a helpful, supportive manner. Job Requirements: * Associate's Degree in Social Work, Health or Human Services field or equivalent combination of education and/or experience. * Bilingual in English/Spanish required. * Administrative experience in health or social service setting. * Knowledge of East Bay health and social service resources. * Previous work providing services to persons who are disabled, homeless, substance users, and/or psychologically impaired. * Proficient in Microsoft office word with ability to manage databases.

Concierge Navigator-Advocate External Description: Concierge Navigator- Advocate The Concierge Navigator Advocate provides outreach and support to ensure all our members have access to the care they deserve. You will navigate our members through their health care and benefits, and connect the dots between our provider network, health plan operations, and supplemental vendors. You will be alongside our members every step of the way to ensure they are never alone in their healthcare journey. This is a role for a passionate and experienced customer service representative who understands the meaningful contribution they make to our members' healthcare outcomes. Essential Duties and Responsibilities: Essential duties and responsibilities of the Concierge Navigator- Advocate include, but are not limited to: Be knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries; serve as a “subject matter expert” in the health care experience that our members navigate daily Responsible for conducting member outreach phone calls and/or receiving inbound phone calls within the department's goal timeframe; manage to the member's communication preferences as possible, which may include time of day, channel, and language; utilize interpreter service as needed Collaborate with our partners - including but not limited to other departments, supplemental benefit vendors, and provider network - to facilitate the member experience Identify members targeted for care gaps and other campaigns, and connect members to programs or services when appropriate; analyze available programs, determine program eligibility, and connect member to appropriate provider or vendor Responsible for real-time documentation and timely wrap-up to support outcomes reporting in all systems/applications as required; must enter member demographics and information with accuracy and attention to detail, i.e. feel responsibility for the quality of our organizational data Responsible for meeting or exceeding individual and team goals, and for submitting activity reports in the format and frequency required Excel in customer service and contribute to a culture of going “above and beyond” to ensure the highest level of member satisfaction Must participate in all required team meetings and trainings, and exhibit satisfactory understanding of new information and process Adhere to all applicable attendance and productivity policies Support other projects and duties as assigned by Management Supervisory Responsibilities This job has no supervisory responsibilities. Minimum Requirements Experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations Experience helping members navigate their Medicare Advantage benefits including medical, prescription drug, and supplemental benefits Outbound call center experience which may include welcome/onboarding, appointment scheduling, retention, sales, or other health care/health plan related programs; and/or inbound call center experience that indicates a higher level of problem-solving such as escalation or resolution Must be available to work full-time and over-time through the Annual Enrollment Period (Oct-Dec) and Open Enrollment Period (Jan-Mar) Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High school diploma or general education degree (GED); two to three years related experience and/or training; or equivalent combination of education and experience. Certificates, Licenses, Registrations: None required Other Qualifications - preferred, but not required: Bilingual English/Spanish, or Vietnamese, Chinese (Mandarin), Korean Independently motivated self-starter who can prioritize work assignments and make every day a productive day Team player willing to help and support colleagues, and do their part to support us all reaching our organizational goals Natural “teacher” with the ability to learn plans and describe/explain/educate healthcare coverage and services to our members Genuine passion for customer service Skills and Abilities: Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Mathematical Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance. Reasoning Skills: Ability to apply common sense understanding to carry out detailed, but un-involved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. Computer Skills: Strong computer skills. Other Skills and Abilities: * Computer literate, typing 40+ words per minute. * Excellent communication skills, oral, and written. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. City: Remote - CA State: California Location City: Remote - CA Schedule: Full Time Location State: California Community / Marketing Title: Concierge Navigator Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

Risk Adjustment Provider Engagement Lead External Description: Risk Adjustment Provider Engagement Lead Job Number1193 San Jose,California Position Summary: Responsible for building relationships with our external physicians while conducting medical record reviews, monitoring and analyzing coding patterns, and providing onsite education. Provide coding expertise as well as administrative oversight to improve the overall quality of the documentation; ensuring that it is to the highest level of specificity in accordance to the CMS guidelines. General Duties/Responsibilities: Validate provider documentation for accuracy by reviewing and analyzing samples of coding and claims extracts compared to actual medical records. Track and report progress of the chart reviews performed on the external physicians to assure the coding accuracy and quality of the data submitted to CMS is accurate to the highest level of specificity. Develop education materials to assist physicians in accurately assessing patients' overall health status. Provides feedback to providers on performance improvement opportunities; tracks and prioritizes projects to improve coding and documentation outcomes. Maintain a comprehensive tracking and management tool for assigned physicians within Alignments Healthcare provider network. Identify issues, determine impact to risk adjustment models, and report results timely to ensure that physicians remain in compliance. Conduct onsite provider education and training regarding risk adjustment to help ensure and increase the accuracy of the member's health status. Present progress and results to leadership on a routine basis. Assist with CMS Risk Adjustment Data Validation activities to ensure our external physicians and Alignment Healthcare is prepared for and will pass an audit. Regularly update all Risk Adjustment materials with clinical and/or official guideline changes. Suggest, update, and enhance clinical educational materials to assist in training physicians and clinical staff on Risk Adjustment Healthcare Programs including CMS-HCC Models, Clinician Chart Reviews, and Encounter Documentation. Suggest customizations of Risk Adjustment education for various audiences; Support Staff, PCPs, Specialists, Employees vs. contracted and Central Departments Stay current of industry coding, compliance and HCC issues. Utilize, protect, and disclose Alignment Healthcare patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies. Other duties as assigned to meet the organization's needs. Supervisory Responsibilities: N/A Minimum Requirements: Minimum Experience: Three-five years of coding in a medical group or health plan setting required; Professional Coding experience required. Previous use of Epic, Allscripts, EZCap a plus Proficient user in MS office suite, MS access a plus Local travel is required Education/Licensure: Bachelor's degree in Business Administration, health Care Management or in a related field or equivalent experience preferred. A nursing degree is preferred. Licenses/Certifications: CPC, CPC-H, CCS, CCS-P, RHIT, RHIA, OR CPMA required. Other: Experience with strategic planning in risk mitigation. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************. City: San Jose State: California Location City: San Jose Schedule: Full Time Location State: California Community / Marketing Title: Risk Adjustment Provider Engagement Lead Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

Supporting Community Healthcare is a rewarding role. LifeLong Medical Care is looking for an Eligibility Specialist at our Admin site in Berkeley. As part of the health center front office team, prepares and submits required eligibility screening and information for all patient visits at the health center. Also responsible for providing enrollment, assistance, information and support to new and established patients in determining eligibility for health services under various private and public health care assistance programs. Also serve as patient registrar and navigator for new patients to their health center. Provide screening and enrollment at community outreach events. This is a full time, 40 hours/week, benefit eligible position. This position is represented by SEIU-UHW. Salaries and benefits are set by a collective bargaining agreement (CBA), and an employee in this position must remain a member in good standing of SEIU-UHW, as defined in the CBA. LifeLong Medical Care is a large, multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. Benefits Compensation: $20 - $21/hour. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including ten paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan. Responsibilities Responsible for preparing all eligibility information for each scheduled clinic patient at least two days ahead of the appointed time. Works collaboratively with front desk staff to ensure that all scheduled and non-scheduled patients are checked for eligibility and that all information is entered accurately and thoroughly. Enters pertinent patient messages and eligibility alerts in patient's chart where needed to communicate with front office and billing department regarding patient eligibility Interviews and screens new and established patients to determine eligibility for health insurances and other programs including Medi-Cal, Covered California, CalFresh, HealthPAC and Contra Costa CARES. Assists patients and community members with completing and submitting applications for county and state benefit programs including Covered California. Registers new patients, schedules appointments and provides information on LifeLong Medical Care's locations, services and available programs. As part of health center front office team, assists with front office operations at the health center as needed. Responsible for tracking and reporting all required data for enrollment and outreach efforts. Keeps appropriate statistical records. Attends all meetings that apply to the eligibility process and shares the information with appropriate clinic personnel. These meetings are typically off-site and may require the use of personal vehicle or other transit. Follows up on incomplete applications in OEA and CalHEERS within 30 days. Schedules Medi-Cal appointments for patients to meet with On-site Eligibility Workers. Takes all classes and test to become a Certified Enrollment Counselor Performs other duties and projects as assigned. Qualifications Strong organizational skills and ability to work effectively under pressure in a positive, friendly manner. Excellent verbal and written communication skills. Must be able to communicate at all levels. Patient and compassionate when interacting with patients and staff. Ability to work independently and as a team player with staff and volunteers. Work in a team-oriented environment with a number of professionals with different work styles and support needs. Excellent interpersonal, verbal, and written skills and ability to effectively work with people from diverse backgrounds and be culturally sensitive. Conduct oneself in external settings in a way that reflects positively on LifeLong Medical Care as an organization of professional, confident and sensitive staff. Ability to see how one's work intersects with that of other departments of LifeLong Medical Care and that of other partner organizations. Make appropriate use of knowledge/ expertise/ connections of other staff. Be creative and mature with a “can do”, proactive attitude and an ability to continuously “scan” the environment, identifying and taking advantage of opportunities for improvement. Job Requirements High school diploma or GED. Two years' experience in a community health care environment or primary care setting. Experience with One e-App and Cal-Win Knowledge of Medicare, Medi-Cal, HMO and PPO health insurance policies and procedures. Proficient in Microsoft office suite, able to type 35 wpm and produce spreadsheets, tables, and flyers. Job Preferences Some college preferred. Bilingual English/Spanish preferred.

The Homeless Services Clinic Coordinator is responsible for overseeing the admin needs of clinics offered within homeless services programs. The HSCC plans programs clinic schedules, manages supplies and inventory, assists clinic and program providers to facilitate patient care, conducts patient outreach, oversees admin of contingency management, facilitates referrals, troubleshoots insurance eligibility issues, and provides patient health education. Responsibilities Essential Functions Conduct patient intakes, registers new patients, and maintains accurate medical records Register new patients and scan necessary documents in the Electronic Health Record Look up and enter insurance information into individual health records and trouble shoot eligibility issues Maintain up to date patient demographic and insurance information in agency clinic management and health record systems Maintain provider visit schedule of appointments and provide regular reminders to providers of their scheduled appointments Work with on-duty staff to conduct regular outreach effort to patients to and ensure patients attend scheduled appointments on time Manage patient flow during clinic hours, including check in and check out Assure that clinics have necessary supplies, that clinic facilities are set up prior to scheduled clinic time, and exam rooms are stocked appropriately prior to patient appointments Conduct regular inventory of clinic supplies, submit requisitions for supply orders, and assure out-of-date supplies are disposed of according to relevant agency guidelines Coordinate site waste disposal with appropriate vendors Maintain and record vaccine refrigerator and freezer temperature log Label and organize supplies appropriately to make sure they are retrievable Track patient encounters and enter charges for each completed encounter on a weekly basis Enter and track encounter and billing data to ensure clinic is meeting productivity targets Run insurance and check eligibility for every new patient, at patient intake, and once a month for all patients Assist patients whose Medi-Cal is no longer active or registered in Alameda County to submit applications and recertifications to renew or establish insurance and benefits Contact insurance providers or other funders to obtain authorizations to ensure reimbursement for services Coordinate with case managers, providers, and referral specialists to facilitate referrals for labs, diagnostic tests, specialty care, and follow up appointments Manage day-to-day operational aspects of contingency management and train staff on how to administer rewards Work with site staff to conduct regular outreach efforts to clients Participate in and help conduct group visits at each site Attend all meetings that are required for this position, take notes, and distribute notes to meeting attendees Qualifications Qualifications Commitment to the provision of primary care services for the underserved with demonstrated ability and sensitivity in working with a variety of people from low-income populations, with diverse educational, lifestyle, ethnic and cultural origins. Strong organizational, administrative and problem-solving skills, and ability to be flexible and adaptive to change. Ability to effectively present information to others, including other employees, community partners and vendors. Ability to seek direction/approval on essential matters, yet work independently with little onsite supervision, using professional judgment and diplomacy. Work in a team-oriented environment with a number of professionals with different work styles and support needs. Excellent interpersonal, verbal, and written skills. Conduct oneself in internal and external settings in a way that reflects positively on LifeLong Medical Care as an organization of professional, confident and sensitive staff. Ability to see how one's work intersects with that of other departments of LifeLong Medical Care and that of other partner organizations. Make appropriate use of knowledge/ expertise/ connections of other staff. Be creative and mature with a “can do”, proactive attitude and an ability to continuously “scan” the environment, identifying and taking advantage of opportunities for improvement.

Established in 1987, Pacific Medical, Inc. is a distributor of durable medical equipment; specializing in orthopedic rehabilitation, arthroscopic surgery, sports medicine, prosthetics, and orthotics. With the heart of the company dedicated to helping and serving others, we provide our services directly to the patient, medical networks, physician clinics, and offices. We are dedicated to the advancement of patient care through excellent service and product technology. We have an immediate opportunity to join our growing Ortho Life Orthopedic platform. We are currently seeking a full-time Certified Prosthetist Orthotist for our Salinas, CA Patient Care Facility. This individual will be responsible for the evaluation, fabrication, and custom fitting of artificial limbs and orthopedic braces, specialize in designing and making artificial limbs, designing and fitting orthopedic braces such as surgical supports and corrective shoes, and a willingness to supervise and work with a dynamic team. Job Responsibilities: • Examine, interview, and measure patients in order to determine their appliance needs, and to identify factors that could affect appliance fit. • Fit, test, and evaluate devices on patients, and make adjustments for proper fit, function, and comfort. • Instruct patients in the use and care of orthoses and prostheses. • Design orthopedic and prosthetic devices, based on physicians' prescriptions, and examination and measurement of patients. • Maintain patients' records in accordance with ABC and CMS standards. • Make and modify plaster casts of areas that will be fitted with prostheses or orthoses, for use in the device construction process. • Select materials and components to be used, based on device design. • Confer with physicians in order to formulate specifications and prescriptions for orthopedic and/or prosthetic devices. • Repair, rebuild and modify prosthetic and orthopedic appliances. • Construct and fabricate appliances or supervise others who are constructing the appliances. • Train and supervise orthopedic and prosthetic assistants and technicians, including COF. • Update skills and knowledge by attending conferences and seminars. • Show and explain orthopedic and prosthetic appliances to healthcare workers. • Maintenance of inventory of material in main and any satellite locations. Requirements: • Must be currently licensed and/or certified and in good standing by governing agency in your field of study either ABC or BOC. • Must maintain CME's annually in accordance with ABC and BOC guidelines. • Must practice within your scope of work unless privileged by a supervisor or practitioner of another specialty. • Must adhere to the guidelines as set forth in the employee handbook of Pacific Medical Inc. upon hire. • Must attend and show competency in HIPAA compliance, sexual harassment training, and universal precautions training. • If required by state law must have additional licensing to perform duties in said state/ region. • Maintain compliance with ABC facility accreditation and be a leader in its implementation. • Lead and/or participate as necessary with facility support staff in the annual performance reviews. • Mandatory attendance and participation in Pacific Medical hosted training and meetings. • Interest in pediatrics preferred. • Spanish speaking preferred. Salary Range: $80,000 - $120,000 All Full-Time positions offer the following: Medical, Dental, Vision, ER paid Life for Employee, Voluntary benefits, Medical FSA, Dependent FSA, HSA, 401k, and Financial Wellness planning.

Business Analyst External Description: Business Analyst Alignment Healthcare seeks a motivated Business Analyst to support the implementation and development of its proactive member outreach and engagement programs. The ideal candidate will not only have the skills to meet the job responsibilities, but a genuine passion and understanding for how an innovative customer service approach can anticipate our members' needs and make the difference in their healthcare experience. This position will be a valued partner to our executive leadership. Essential Duties and Responsibilities: Essential duties and responsibilities of the Business Analyst include, but are not limited to: Review, analyze, and evaluate systems and user needs Document requirements, define scope and objectives, and formulate systems Construct workflow charts and diagrams; study system capabilities; write specifications Improve systems by studying current practice and designing modifications; understand and communicate the financial and operational impact of any changes; actively participate in the implementation of approved changes Recommend controls by identifying problems and improving or establishing new policies and standard operating procedures Define project requirements by identifying project milestones, phases, and elements; form project team; establish project budget Monitor project progress by tracking activity; resolve problems; publish progress reports; recommend actions Maintain user confidence and protect operations by keeping information confidential Prepare technical reports by collecting, analyzing, and summarizing information and trends Contribute to team effort by accomplishing related results as needed Validate resource requirements and develop cost estimate models Create informative, actionable, and repeatable reporting that highlights relevant business trends and opportunities for improvement Maintain positive relationships within and between operational departments by coordinating information exchange, keeping stakeholders informed of progress and risks, and maintaining detailed and organized documentation Minimum Requirements: Minimum Experience: Background in health care provider and/or health plan settings, preferably with experience in IT system implementations, provider relations, IPA, revenue cycle management, and/or vendor management. Intermediate to Advanced understanding of project management with a minimum of 3 years of work experience in project management. Intermediate to Advanced proficiency required in MS Office products including Word, Excel, PowerPoint, Visio and MS Project. Education/Licensure: Bachelor's Degree in appropriate field of study or equivalent work experience Other: Intermediate or Advanced proficiency in MS Office products including Word, Excel, PowerPoint, Visio, and MS Project Skills in Microsoft Access and/or SQL, Power BI, or other data tools strongly preferred High-energy: ability to impact operations and affect change Detail oriented, analytical, and inquisitive Ability to work independently and with others Communication skills to bridge people, process, and technology Extremely organized with strong time-management skills Excellent presentation and training skills Motivated to learn and operate with flexibility Ability to prioritize multiple and competing tasks Ability to work well in a fast-paced and dynamic environment Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************. City: Orange State: California Location City: Orange Schedule: Full Time Location State: California Community / Marketing Title: Business Analyst Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

Virtual Concierge Navigator, Medical Asst. External Description: Virtual Concierge Navigator, Medical Assistant The ACCESS On-Demand Concierge is Alignment Healthcare's model to ensure best-in-class service and care coordination 24/7. As a member of this team, you will be at the center of our member experience and the face of Alignment Healthcare. You will provide members with “White Glove” service and act as a guide to help our members navigate their virtual experience and health care overall. The Virtual Concierge Navigator ensures member satisfaction and customer service are provided at the level of excellence that our members deserve. To do so, you will become an expert on our health plan and supplemental benefits, care deliver model, and provider network; you will also serve as the liaison among members, providers, and internal departments. By ensuring an “aligned” experience is available to our members at any time of day or night, over the phone, through video-chat, and messaging. Essential Duties and Responsibilities: Essential duties and responsibilities of the Virtual Concierge Navigator include, but are not limited to: • Be knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries; serve as a “subject matter expert” in the health care experience that our members navigate daily. • Resolve incoming calls concerning members' eligibility, benefits, provider information, clinical, and pharmacy needs; coordinate membership changes such as member's primary care physician and proactively engage member with their wellness plan options. • Collaborate with our partners - including but not limited to other departments, supplemental benefit vendors, and provider network - to facilitate the member experience. • Responsible for receiving inbound phone calls within the department's goal timeframe; may be required to communicate with members in other channels including e-mail, web chat, SMS/text, as required. • Manage to the member's communication preferences as possible, which may include time of day, channel, and language; utilize interpreter service as needed. • Responsible for real-time documentation (i.e., caller name, contact info, call reason, action taken, resolution, etc.) and timely wrap-up to support outcomes reporting, in all systems/applications as required. • Provide administrative support to virtual providers with referrals and initiating authorization requests as deemed appropriate, following up to ensure completion. • Coordinates member's care for PCP care plan, diagnostic tests, radiology, laboratory, and specialty appointments. Ensures appointments are scheduled and confirmed with the member via Alignment's EMR system; confirms demographics entered are complete. Schedules transportation as appropriate. • Manage appropriate clinical escalations and triage; link the member to appropriate clinical resources. • Verify the member is included in or targeted for any outreach or care gap programs and connect members to programs (such as chronic disease programs) or services when appropriate. Analyze available programs, determine program eligibility, and assists with enrollment of such program as appropriate. • Monitor communication channels as assigned and manage replies to ensure all metrics for timeliness and member experience success are met. • Develop, write, and edit digital replies, which may involve coordination of health plan benefits knowledge, reference documents, member resources, insights from key stakeholders, and more to be determined. • Follow communication “scripts” and/or templates as appropriate, ensuring the consumers' needs are clearly understood and resolved. • Excel in customer service and contribute to a culture of going “above and beyond” to ensure the highest level of member satisfaction. • Adhere to all applicable attendance policies to ensure consistent and reliable queue coverage, which is essential to the member experience. Supervisory Responsibilities This job has no supervisory responsibilities. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Education and/or Experience: High school diploma or general education degree (GED). 2. Certificates, Licenses, Registrations: Medical Assistant Certification. Required. 3. Other Qualifications: • Medical front/back office experience. • Knowledge of ICD-10 and CPT codes. • High-volume inbound customer service experience, particularly for health plan or Medicare “Member Services” roles in health plan and supplemental benefits. Preferred. • Telemarketing and/or member outreach experience. Preferred. • Specialized experience in escalation or resolution units. Preferred. Skills and Abilities 1. Communication Skills: Strong communication skills via email and phone. Fluency in written and verbal Spanish, Korean, or Vietnamese, a plus. 2. Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. 3. Mathematical Skills: Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance. 4. Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. 5. Computer Skills: Strong computer skills. 6. Other Skills and Abilities: a. Computer literate, typing 40+ words per minute. b. Excellent communication skills, oral and written. c. Must pass a writing test. Impeccable grammar and spelling. Please note: No time off granted during Onboarding/Training and for Jan 1 - Jan 30, 2021 due to high call volume for calendar year enrollment. Must be willing to work overnight, weekends, and holidays as scheduled. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. 2. The employee is frequently required to walk; stand; reach with hands and arms. 3. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. 4. The employee must occasionally lift and/or move up to 20 pounds. 5. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Working Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. The noise level in the work environment is usually moderate. 2. Remote, work from home positions available. City: Orange State: California Location City: Orange Schedule: Full Time Location State: California Community / Marketing Title: Virtual Concierge Navigator, Medical Assistant Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Alignment health is seeking a bilingual Spanish social worker (Masters of Social Work required) to join the interdisciplinary Care Anywhere team in West / Downtown Los Angeles, California. The Social Worker assess' and evaluates members' needs and requirements to achieve and/or maintain their health. Guides members and their families toward and facilitate interaction with resources appropriate for their care and well-being. Works in collaboration with a multi-disciplinary teams, employing a variety of strategies, approaches and techniques to enable a member to manage their physical, environmental and psycho-social health issues. Schedule: - Monday - Friday, 8:00 AM - 5:00 PM Pacific Time (Required) - (4) Home visits per day (mileage reimbursement provided.) GENERAL DUTIES/RESPONSIBILITIES 1. Conducts telephonic outreach to assigned members to assess health, environment, nutrition, and psycho-social areas of concerns using a variety of assessments. a. In response to assessments, coaches and problem solves with member to identify and address specific goal(s) to support health and behavior change. b. Provides appropriate interventions to optimize health and well-being. Interventions may include education, the coordination of community-based support services, and other resources. c. Charts member's treatments and progress in accordance with state regulations and department procedures. d. Makes referrals to case manager, as appropriate, and/or refers member's family to community support services and resources. 2. Provides home assessment to high-risk members and develop an individual care plan 3. Collaborates with physicians in screening and evaluating members for psychotropic medications. 4. To better serve members and implement the model of care, understands the clinical program design, program monitoring and reporting. 5. Practices as an interdependent member of the health team and provides important components of primary health care through direct social work services, consultation, collaboration, referral, teaching, and advocacy. 6. Assess' and treats outpatients in individual and family modalities exercising mature professional judgment and using a wide range of social work skills to include individual and family counseling to assist patients and their families in dealing with chronic and acute diseases/injuries. 7. Conducts psychosocial assessments to determine patient needs and resources (both family support and community support). Provides counseling to patient and family in matters directly related to patients' limitation, adjustment to medical condition, and ongoing treatment. Develops and implements discharge plans, follow-up care, and transfers to other health care facilities (e.g., nursing homes, rehabilitation hospitals, etc.) 8. Provides consultation services to medical, nursing, and ancillary hospital staff regarding psychosocial issues, discharge plans, and follow-up care for patients and families. 9. Provides crisis intervention services. 10. Responds independently, and with various media, to appropriate community requests. Take the initiative in seeking out opportunities to present programs to meet the needs of patients/members and their families. 11. Consults with Hospital administration, and Plan supplying information and feedback regarding procedures and services provided by the Psychology Division. 12. Develops and maintains working relationships with community resources. Coordinate with physicians, and representatives of their service disciplines for the benefit of the member and their families. Take initiative in identifying and assessing the needs of the community and organize responses to address those needs. 13. Interfaces with the RN Case Manager(s) and the Interdisciplinary Team (IDT) in the development and implementation of the Case Management Program (CMP). 14. Integrates social work case management and nurse case management as a team. Job Requirements: Experience: • Required: Minimum 5 years of experience in care management, assessment, long term member/patient care management or community based resource delivery. 2 year experience with vulnerable adults or older adult population. 1 year experience with motivational interviewing-Ability to apply Motivational Interviewing and Appreciative Inquiry. Education: • Required: Master's Degree in Social Work (MSW) Training: • Preferred: Crisis intervention training Specialized Skills: • Required: Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Intermediate to advanced computer skills and experience with Microsoft Word and Excel. Skill to understand current and potential needs of members to take appropriate action in order to support member in health and well-being changes. Skill in building trust in partnership with member/client/patient. Basic knowledge of complex care management and care management principles. Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Report Analysis Skills: Comprehend and analyze statistical reports. Licensure: Required: Current, valid, unrestricted California Driver's License and reliable transportation. Preferred: Valid unrestricted Social Worker license (LCSW) Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 2 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $77,905.00 - $116,858.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Alignment Healthcare is a data and technology driven healthcare company focused partnering with health systems, health plans and provider groups to provide care delivery that is preventive, convenient, coordinated, and that results in improved clinical outcomes for seniors. We are seeking a mission-driven Data Scientist to join our growing team and support risk adjustment strategy within our Medicare Advantage line of business. This role focuses on enhancing risk score accuracy, CMS audit preparedness (RADV), and building AI-powered tools that improve clinical documentation review and integrity. You'll play a key role in advancing AVA, our proprietary clinical intelligence platform, by developing next-generation models that support autonomous chart review and NLP/GenAI-driven documentation analytics. This is a unique opportunity to work at the intersection of healthcare, compliance, and machine learning-transforming how we ensure both quality and regulatory alignment. Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Alignment Healthcare is a data and technology driven healthcare company focused partnering with health systems, health plans and provider groups to provide care delivery that is preventive, convenient, coordinated, and that results in improved clinical outcomes for seniors. We are seeking a mission-driven Data Scientist to join our growing team and help develop predictive models and intelligent workflows that drive better member health outcomes, improve quality metrics, and enhance operational efficiency across our Medicare Advantage offerings. You'll work on a diverse portfolio of high-impact projects spanning clinical intelligence, quality improvement, payment integrity, and emerging AI/NLP solutions, all underpinned by our proprietary AVA technology platform. This is a unique opportunity to work at the intersection of healthcare, machine learning, and real-world impact, applying advanced analytics to solve complex problems that improve the quality of healthcare for our members. Job Duties/Responsibilities Collaborate with business stakeholders to understand complex healthcare and operational challenges, then design and implement analytical solutions that drive measurable outcomes Develop predictive models and workflows for AVA, our proprietary clinical intelligence platform, supporting autonomous chart review, clinical analytics, disease detection, and compliance forecasting Build and deploy scalable model pipelines that integrate NLP, random forests, gradient boosted algorithms, ensemble models, and data processing using Python, R, Databricks, MLFlow, and Unity Catalog Design and implement quality improvement models in partnership with our Quality team to enhance member health outcomes, improve Stars ratings, and support HEDIS reporting and forecasting initiatives Develop automated validation and quality assurance models for the Payment Integrity team to improve accuracy and reduce manual review burden Build AI / NLP / LLM solutions for document understanding, including the training of vision detection algos and development / deployment of OCR and NER pipelines that process medical charts at scale Collaborate with engineering teams to version, test, and deploy models using Git, CI/CD pipelines, GitHub, Azure, and cloud-based infrastructure Design algorithms to predict audit risk and detect documentation anomalies across cohorts and markets, supporting RADV audit preparedness and CMS compliance Partner cross-functionally with Pharmacy, Actuaries, Clinical, Data Engineering, and Software Engineering teams to ensure analytical outputs align with CMS guidance and regulatory requirements Support CMS Star Ratings strategy, including HEDIS, CAHPS, and HOS analysis and predictive modeling, and root cause analysis on rate movement through the measurement year Help standardize definitions, documentation logic, and reporting workflows at scale for enterprise-wide AI readiness and analytical capabilities Supervisory Responsibilities: N/A MINIMUM REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimum Experience: 2+ years of relevant experience in predictive modeling, machine learning, and data science Demonstrated ability to build end-to-end data science solutions with measurable real-world impact Education/Licensure: Preferred: MSc or PhD in Computer Science, Engineering, Mathematics, Statistics, or related field, OR equivalent professional experience Other: Strong programming proficiency in Python and/or R (primary focus for this role) Solid understanding of data structures, algorithms, and software engineering principles Demonstrated proficiency in SQL and relational databases Experience with Git and version control workflows Deep knowledge of machine learning algorithms, including deep neural networks, NLP, and LLMs Experience manipulating and analyzing complex, high-volume, high-dimensionality, and unstructured data from multiple sources Expertise in experimental design, statistical rigor (confidence intervals, significance testing, train/test/validation methodology) Strong data visualization and presentation skills; ability to translate complex analysis into actionable insights Excellent communication and collaborative problem-solving abilities Demonstrated ability to thrive in ambiguous, fast-paced environments while prioritizing effectively Strong analytical mindset with attention to detail and commitment to data quality Preferred Qualifications: Healthcare industry experience or familiarity with healthcare data challenges Hands-on experience with Databricks for distributed data processing and ML workflows Experience with MLFlow and Unity Catalog for model versioning and governance Experience with Azure, AWS, or other cloud ecosystems Familiarity with NoSQL databases Knowledge of CMS and Medicare Advantage operations Published work in academic conferences or industry circles Experience with containerized environments and CI/CD pipelines Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL PHYSICAL FUNCTIONS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $149,882.00 - $224,823.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.

Manager, Member Engagement External Description: Manager, Member Engagement This management position will oversee our outreach teams that are dedicated to proactive member engagement. The Manager, Member Engagement is at the helm of our outbound contact center strategy and operations. As you drive process improvement and team performance, we will build an exceptional service-oriented culture that anticipates our members' needs. Essential Duties and Responsibilities: Essential duties and responsibilities of the Manager, Member Engagement include, but are not limited to: Partner with executive leadership to determine and understand contact center operational strategy by conducting needs assessments, performance reviews, capacity planning, workforce management, and cost/benefit analysis Conduct candidate interviews, make hiring decisions, and oversee successful new employee onboarding Monitor the activities and productivity of all staff in office and remote (work from home) locations; ensure quality assurance; deliver related reporting to executive leadership as required Evaluate the performance of direct reports, and provide coaching, counsel, performance improvement plans, etc. in regular performance review meetings Champion team engagement and create a culture of service excellence, positivity, and teamwork Create, implement, and test new workflows and processes Coordinate work activities with other leadership and departments to streamline the member experience and identify efficiencies for the business Serve as a team representative in meetings and audits as required Lead by example: demonstrate reliability and accountability in attendance and the quality of your work product; ensure a culture of professionalism and discipline Other assignment and projects as assigned Minimum Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimum Experience: five (5) years of Call Center experience including at least three (3) years in a management capacity in a compliance-driven industry; previous health plan and/or Medicare Advantage experience preferred Education and/or Experience: Bachelor's degree, or equivalent experience Certificates, Licenses, Registrations: None required Other Qualifications - preferred, but not required: Proven track record to monitor and motivate employees; experience that includes oversight of remote workforce and/or vendor a plus Demonstrated success with implementation and/or management of applications including workforce management, CRM, campaign manager, EMR PM, etc. Excellent communication skills, both written and verbal; bilingual English/Spanish preferred Strong interpersonal skills and a collaborative management style Attention to detail, with sound critical thinking and follow up skills Ability to manage multiple priorities simultaneously with timelines and short turn-around times Advanced computer skills (Outlook, Excel, PowerPoint, Word) required Genuine passion and goals for career-level customer service City: Orange State: California Location City: Orange Schedule: Full Time Location State: California Community / Marketing Title: Manager, Member Engagement Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Scheduling Specialist provides outreach and support to ensure all our eligible members have access to the care they deserve around our available Clinical/Patient Programs. Assists in navigating our members through the different programs they may be eligible and assists in scheduling them for what best suits their needs. Navigates with our members every step of the way to ensure they are never alone in their healthcare journey. Utilizes excellent customer service measures and understand the meaningful contribution the team makes to our members' healthcare outcomes. Job Duties/Responsibilities: 1. Serves as a “subject matter expert” in the clinical programs that our members may be eligible for. This includes being knowledgeable in procedures, scheduling for Health Assessments, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries. 2. Conducts member outreach phone calls and/or receiving inbound phone calls within the department's goal timeframe; manage to the member's communication preferences as possible, which may include time of day, channel, and language; utilize interpreter service as needed. 3. Collaborates with our partners - including but not limited to other departments, Member Services, and Clinical Departments - to facilitate the member experience. 4. Identifies members targeted for care gaps and other campaigns, and connect members to programs or services when appropriate; analyze available programs, determine program eligibility, and connect member to appropriate provider or vendor 5. Responsible for real-time documentation and timely wrap-up to support outcomes reporting in all systems/applications as required; must enter member demographics and information with accuracy and attention to detail, i.e. feel responsibility for the quality of our organizational data 6. Responsible for meeting or exceeding individual and team goals, and for submitting activity reports in the format and frequency required 7. Excels in customer service and contributes to a culture of going “above and beyond” to ensure the highest level of member satisfaction. 8. Other duties as assigned. Job Requirements: Experience: • Required: Minimum 1 year of call center experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations. • Preferred: Experience in Clinical setting in managing provider schedules. Experience helping members navigate their Medicare Advantage benefits including medical, prescription drug, and supplemental benefits. Call Center experience in welcome/onboarding, appointment scheduling, retention, sales, or other health care/health plan related programs; and/or inbound call center experience that indicates a higher level of problem-solving such as escalation or resolution Education: • Required: High School Diploma or GED. • Preferred: College courses Training: • Required: • Preferred: Specialized Skills: • Required: Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Mathematical Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance. Reasoning Skills: Ability to apply common sense understanding to carry out detailed, but un-involved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. Computer Skills: Strong computer skills. typing 40+ words per minute. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. • Preferred: Bilingual English/Spanish, or Vietnamese, Chinese (Mandarin), Korean Licensure: • Required: None Other: • Required: Must be available to work full-time and over-time through the Annual Enrollment Period (Oct-Dec) and Open Enrollment Period (Jan-Mar) Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $41,600.00 - $57,600.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.

Nurse Health Specialist External Description: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. Position Summary: Provides primary care services to patients in both a clinic and home care setting. Responsible for managing patient care and treatment in collaboration with the Physician and Advanced Practice Clinician. General Duties/Responsibilities: (May include but are not limited to) Conduct in home assessments on health plan member. Collaborates with primary care physician, Extensivist, and Advanced Practice Clinician, and Case Manager to develop care plan for members. Perform diagnostic and/or therapeutic procedures within his/her level of training and expertise, and as outlined on the practice agreement and written protocol with the supervising physician. Interprets and evaluates diagnostic tests to identify and assess patients' clinical problems and health care needs. Educates members on topics such as disease process, end of life, medication, and compliance. Discusses case with Physician and Advanced Practice Clinician when appropriate. Use of Electronic Medical Records required. Minimum Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Minimum Experience: a. Knowledge of clinical standards of care b. Minimum 1 year experience as an RN c. Minimum 5 years' experience as an LVN 2. Education/Licensure: a. Requires successful completion of an accredited Nursing Program; BSN preferred, Registered Nurse preferred, LVN considered with appropriate experience b. Current, unrestricted license in the state for which you are applying c. Must have CPR certification d. Must have valid driver's license and automobile insurance 3. Other: a. Experience in gerontology, adult care, preferred b. Experience in palliative/hospice and complex care management, preferred c. Experience in Home Health including wound care, preferred d. Knowledge of Medicare Managed Care Plans, preferred e. Excellent administrative, organizational and verbal skills f. Effective communication skills with seniors g. Computer literate and able to navigate the internet h. Ability to work independently i. Detail oriented j. Dependable and reliable k. EMR experience is strongly preferred l. Bilingual skills valued (Spanish preferred) m. Must be flexible with traveling between regions as needed to meet business needs. 4. Work Environment: a. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************. City: San Jose State: California Location City: San Jose Schedule: Full Time Location State: California Community / Marketing Title: Nurse Health Specialist Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

Established in 1987, Pacific Medical, Inc. is a distributor of durable medical equipment; specializing in orthopedic rehabilitation, arthroscopic surgery, sports medicine, prosthetics, and orthotics. With the heart of the company dedicated to helping and serving others, we provide our services directly to the patient, medical networks, physician clinics, and offices. We are dedicated to the advancement of patient care through excellent service and product technology. We have an immediate non-remote opportunity to join our growing company. We are currently seeking 3 full-time (M-F 8:00 am-5:00 pm) Patient Collections Specialists for our Tracy, CA office. These individuals will be responsible for the following: * Must be Bilingual (Spanish) * Job Responsibilities: · Contact patients/guarantors to secure payment for services provided based on an aging report with balances. · Contact patients when credit card payments are declined. · Follow up with refund requests. · Document all calls and actions are taken in the appropriate systems. Sets next work date if follow-up is needed. · Confirms/updates with patient/guarantor insurance and patient demographics information. Makes appropriate changes and submits/re-submits claims as indicated. · Establishes a payment arrangement with the patient/guarantor and follow-up on all payment arrangement plans implemented. · Document all patient complaints/disputes and forward them to the appropriate person for follow-up. · Perform other duties as needed. Qualifications/Skills: · Must excel in interpersonal communication, customer service and be able to work both independently and as part of a team. · Must excel in organizational skills. · Must possess strong attention to detail and follow-through skills. · Education, Training, and Experience Required: High School graduate or equivalent. Bilingual (Spanish) Must type 25-45 words per minute. Hourly Rate Pay Range: $17.00 to $19.00 · Annual Range ($35,360.00 to $39,520.00) O/T Rate Pay Range: $25.50 to $28.50 · Example of Annual O/T Range (5 to 10 hours per week @ 50 weeks range $6,375.00 - $14,250+) · Note: Abundance of O/T Available Bonus Opportunity Team Bonus: $0 to $500 per month (increases hourly rate up to $2.88 per hour or up to $6k per year) Profit Bonus: $0 to $500 per month (increases hourly rate up to $2.88 per hour or up $6k per year) Total Compensation Opportunity Examples: Annual Base Pay: $41,735 (Estimate incl. 5 hrs O/T per week, Low-range Production and Profit Bonus after 3 months) Annual Mid-Range Pay: $54,315.00 (Estimate incl. 5 hrs O/T per week, Mid-range Production and Profit Bonus) Annual Top Pay: $57,895.00 (Estimate incl. 5 hrs O/T per week, Max Production and Profit bonus) All Full-Time positions offer the following: Medical, Dental, Vision, ER paid Life for Employee, Voluntary benefits, Medical FSA, Dependent FSA, HSA, 401k, and Financial Wellness planning. Additional Benefits for Full-Time Employees (3 to 4 weeks of Paid Time Off) Holidays: 10 paid holidays per year Vacation Benefit: At completion of 3-month introductory period, vacation accrual up to a max of 40 hours in the first 23 months, at 24 months, accrual up to a max of 80 hours with a rollover balance. Sick Benefit: Sick accrual begins upon date of hire up to a max accrual of 80 hours annually with a max usage of 48 hours annually with a rollover balance.