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Mission Veterinary Partners jobs - 192 jobs

  • Janitorial Team Member

    Mission Veterinary Clinic & Animal Emergency Hospital 3.8company rating

    Mission Veterinary Clinic & Animal Emergency Hospital job in Hillsborough, CA

    Join Our Team as a Janitorial Team Member! Looking for a fulfilling role where you can make a difference every day? Mission Veterinary Clinic & Animal Emergency Hospital in Granada Hills, CA, is searching for a dedicated Janitorial Team Member to help us maintain a clean, safe, and welcoming environment for our clients, their pets, and our team. At Mission Veterinary Clinic, we pride ourselves on providing exceptional care to animals and their owners. As part of our team, you'll play a vital role in ensuring our facility reflects the high standards of care we deliver. What You'll Be Doing As a Janitorial Team Member, your primary responsibility will be to keep our clinic spotless and running smoothly. Your day-to-day tasks will include: - Cleaning and sanitizing all areas of the facility, including exam rooms, waiting areas, and restrooms. - Emptying trash, replacing liners, and ensuring waste is disposed of properly. - Sweeping, mopping, and vacuuming floors to maintain a tidy and hygienic environment. - Restocking supplies such as paper towels, soap, and cleaning products. - Assisting with light maintenance tasks to keep the facility in top shape. Your efforts will directly contribute to a clean and comfortable space where pets and their families feel at ease. What We're Looking For To succeed in this role, you'll need: - At least 1 year of experience in janitorial or cleaning services. - A strong work ethic and attention to detail. - The ability to work independently and efficiently. - A commitment to maintaining a safe and sanitary environment. - A positive attitude and willingness to be part of a team that values collaboration and care. Why Join Mission Veterinary Clinic? While we don't offer additional benefits for this role, we can promise you'll be joining a team that values hard work, dedication, and the love of animals. At Mission Veterinary Clinic, we believe every role is critical to our success, and we're proud to foster a supportive and respectful workplace. Ready to Apply? If you're ready to bring your skills and enthusiasm to our team, we'd love to hear from you! Join us at Mission Veterinary Clinic & Animal Emergency Hospital and help us create a clean and welcoming space for pets and their families. Apply today and take the first step toward becoming an essential part of our mission!
    $34k-42k yearly est. 17d ago
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  • Veterinary Assistant - Urgent Care

    Mission Veterinary Clinic & Animal Emergency Hospital 3.8company rating

    Mission Veterinary Clinic & Animal Emergency Hospital job in Hillsborough, CA

    Join Our Team as a Veterinary Assistant - Urgent Care Make a difference in the lives of pets and their families every day! About Us At Mission Veterinary Clinic & Animal Emergency Hospital, we are dedicated to providing exceptional care to pets and peace of mind to their owners. Located in Granada Hills, CA, our clinic specializes in both routine and urgent care, ensuring every patient receives the attention they deserve. We pride ourselves on fostering a supportive and compassionate environment for our staff and clients alike. Position Summary We are seeking a skilled and caring Veterinary Assistant - Urgent Care to join our dedicated team. In this role, you'll work closely with our veterinarians and support staff to provide high-quality care to animals in need. If you have a passion for animal health and at least one year of experience in a veterinary setting, we'd love to hear from you! Key Responsibilities As a Veterinary Assistant - Urgent Care, you'll play a vital role in our clinic by: - Assisting veterinarians with exams, treatments, and procedures. - Monitoring and caring for pets during their stay, ensuring they are comfortable and safe. - Preparing and maintaining exam rooms, surgical areas, and equipment. - Communicating with pet owners, providing updates and compassionate support. - Handling administrative tasks such as patient records and scheduling as needed. Required Skills and Qualifications To succeed in this role, you'll need: - At least 1 year of experience in a veterinary assistant or similar role. - A genuine love for animals and a commitment to their well-being. - Strong communication and interpersonal skills to interact with both team members and pet owners. - The ability to work in a fast-paced environment, especially during urgent care situations. - A proactive attitude and attention to detail when handling tasks and patient care. Why Join Mission Veterinary Clinic? You'll be part of a team that values collaboration, compassion, and excellence in care. Every day brings new challenges and opportunities to grow, both personally and professionally, as you make a meaningful impact on the lives of pets and their families. Our Culture and Values At Mission Veterinary Clinic & Animal Emergency Hospital, we believe in treating every pet as if they were our own. Our team is passionate, hardworking, and dedicated to providing the highest standard of care. We foster a supportive work environment where everyone's contributions are valued, and we encourage continuous learning and growth. Ready to Join Us? If you're ready to take the next step in your veterinary career, we'd love to hear from you! Apply today and become a part of a team that's committed to making a difference-one pet at a time.
    $36k-44k yearly est. 3d ago
  • Telesales / Retention Representative

    Alignment Healthcare 4.7company rating

    Orange, CA job

    Telesales Retention Representative External Description: Telesales / Retention Representative Looking for an enthusiastic Telesales/Retention Representative who will be responsible for generating leads to meet and exceed individual sales production of new enrollments and help retaining existing members within company health plan(s). The ideal candidate must be friendly, professional and genuinely interested in the needs of our prospects/members to proactively address various customer related needs. The Telesales Representative reports to the Telesales Manager. General Duties/Responsibilities: (May include but are not limited to) Responsible for meeting and exceeding monthly goal and retention of existing members. Handle inside/in-bound telephone inquiries from prospective members, providers, and other community partners seeking information regarding all lines of business Direct prospects to the field sales team when needed Conduct outbound calls relevant to enrollment/disenrollment campaigns, requests for information from community events, provider offices, after-hour messages, and website inquiries Submit daily activity production reports and/or monthly reports as required. Ensure that information and assistance provided is within the standards established by all applicable federal /state laws and regulations and Alignment Health Plan's Compliance Department Understanding of new updates related to company and/or CMS and marketing guidelines required. Participate with competitor analysis (SWOTs) Strength, Weakness, Opportunities and Threats within respective market(s) and/or territories as required by management. Support other projects within the Sales and Marketing Department as directed by the Management Team Must be a team player, share best practices, and attend staff meetings and sales trainings when required. Other duties may be assigned. Supervisory Responsibilities: This position has no direct employee supervisory responsibilities. Minimum Requirements: Minimum Experience: Strong knowledge and understanding of the CMS Marketing Guidelines. Medicare Health Plan knowledge and/or health insurance sales background preferred. Minimum of 1 year of inside business to consumer sales experience and/or clinical and/or community outreach; Telesales experience using call center scripts highly desirable Education/Licensure: Must have and maintain active Health/Accident/Life insurance license within respective selling states, currently CA (required), NC, and FL (preferred). Other: Bilingual Flexibility with schedule depending on needs A self-starter who is a team player and extremely organized. Ability to learn plans and describe/explain them to prospects Excellent communicator and presentation skills. Solid computer skills (Word, Excel and PowerPoint). Essential Physical Functions: While performing the duties of this job, the employee is regularly required to talk and listen. The employee regularly is required to sit for long period of time during Annual Enrollment Period. City: Orange State: California Location City: Orange Schedule: Full Time Location State: California Community / Marketing Title: Telesales / Retention Representative 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 ******************.
    $59k-67k yearly est. Easy Apply 60d+ ago
  • Director, RADV Audit Operations

    Alignment Healthcare 4.7company rating

    Orange, CA job

    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 Director of RADV Audit Operations is responsible for managing and overseeing the tactical and opera-tional aspects of the RADV audit process, including medical record retrieval, coding validation, and audit logistics. This role ensures compliance with CMS timelines, quality standards, and cross-department coordination for all RADV-related operational activities at Alignment. Job Responsibilities: Process management: Leading all phases of the audit process, including data sample validation, medical record retrieval, coding abstraction, quality assurance auditing and submission to CMS. Strategy and planning: Responsible for developing and implementing strategies to improve overall coding accuracy and documentation integrity, which mitigates future audit risk. Cross-functional collaboration: Working closely with other departments-such as IT, Risk Adjustment Operations, Provider Relations, and Compliance-to ensure accurate data submission and a smooth audit process. Oversee medical record retrieval processes, ensuring HIPAA compliance and timely submissions. Manage teams of auditors, coders, and project managers to execute end-to-end CMS RADV workflows. Coordinate with vendors and internal partners for coding reviews and documentation validation. Ensure the accuracy and completeness of HCC submissions during RADV cycles. Track progress and performance metrics; escalate risks to leadership as needed. Develop and maintain standard operating procedures (SOPs & P&Ps) for audit workflows. Monitors coder and physician audit results to maintain quality of information. Maintains current information on governmental regulation changes and updates affecting coding, staffing and reimbursement. Supervisory Responsibilities: Perform management responsibilities including but not limited to involvement in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct, and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority. Job Requirements: Experience: Required: 5+ years of experience in risk adjustment, Medicare Advantage operations, and managing CMS or other regulatory audits. Preferred: 3+ years of experience in a leadership role and health plan medical coding processes and procedures Education: Required: Bachelor's degree in a relevant field Preferred: Professional certifications such as Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC) or Certified Coding Specialist (CCS) are highly desirable. Specialized Skills: Required: Deep knowledge of the CMS-HCC Risk Adjustment model, ICD-10 coding guidelines, and the end-to-end RADV process is essential. Familiarity with Medicare regulations and compliance requirements is also critical. Strong leadership, communication, and project management skills are required to oversee complex, time-sensitive audits. 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 ******************.
    $149.9k-224.8k yearly Auto-Apply 60d+ ago
  • Data Analyst

    Alignment Healthcare 4.7company rating

    Remote or Garden Grove, CA job

    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 ******************.
    $62k-83k yearly est. Easy Apply 60d+ ago
  • Business Analyst

    Alignment Healthcare 4.7company rating

    Orange, CA job

    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 ******************.
    $93k-123k yearly est. Easy Apply 60d+ ago
  • Bilingual Spanish Social Worker (Home visits in West / Downtown Los Angeles)

    Alignment Healthcare 4.7company rating

    Los Angeles, CA job

    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 ******************.
    $77.9k-116.9k yearly Auto-Apply 60d+ ago
  • Risk Adjustment Provider Engagement Lead

    Alignment Healthcare 4.7company rating

    San Jose, CA job

    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 ******************.
    $70k-95k yearly est. Easy Apply 60d+ ago
  • Concierge Navigator

    Alignment Healthcare 4.7company rating

    Remote or Garden Grove, CA job

    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 ******************.
    $39k-49k yearly est. Easy Apply 60d+ ago
  • Pharmacy Technician - Hybrid (Orange, CA)

    Alignment Healthcare 4.7company rating

    Remote or Orange, CA job

    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. Location: California Corporate Office | Remote Type: Hybrid Remote Schedule: Full-Time | 40 Hours/Week Join Our Team and Make a Difference in Healthcare Are you a licensed Pharmacy Technician with a passion for healthcare, detail, and helping others? We're looking for a motivated and customer-focused professional to support the day-to-day operations of our Pharmacy Department. In this hybrid role based out of our Orange, CA office, you'll be at the heart of supporting key programs that help improve patient outcomes and maintain compliance with industry regulations. This is more than a support role - it's an opportunity to make a real impact. What You'll Do: As a Pharmacy Technician, you'll provide essential administrative and clerical support that keeps our Pharmacy Department running smoothly. You'll be involved in multiple programs and projects and ensure members receive the medications they need. Your day-to-day responsibilities will include: Making high-volume outbound calls to members, providers, and pharmacies for medication adherence programs. Assisting members with medication refills and coordinating with prescribers for authorizations. Responding to inquiries from members, physicians, and pharmacies regarding prescription benefits. Collaborating with our Pharmacy Benefit Manager (PBM) to resolve prior authorization issues and rejections. Maintaining member confidentiality per HIPAA standards. Supporting internal departments to resolve pharmacy-related issues. Ensuring all pharmacy programs align with compliance standards and CMS criteria. Performing other duties as needed to support the team. What We're Looking For: Required: High School Diploma or GED Active Pharmacy Technician License (CA) At least 1 year of customer service experience Strong written and verbal communication skills Knowledge of pharmacy terminology, dosage forms, and medication applications Proficiency in multitasking and prioritizing work in a fast-paced environment Ability to problem-solve and collaborate cross-functionally Strong organizational and time management skills Preferred: Associate's Degree or completion of Pharmacy Tech school Certified Pharmacy Technician (CPhT) Pharmacy experience in a healthcare setting Bilingual - English/Spanish or English/Chinese Why Join Us? We are committed to improving the health and well-being of our members and community. When you join our team, you'll work in a collaborative and mission-driven environment that values innovation, accountability, and compassion. Work Environment: Hybrid remote work with a supportive and inclusive team. Mon/Wed or Tues/Thurs in office based on availability. In office hours are 7:30am - 4pm. When working from home 8am - 5pm PST Home Internet requirements: 50/download 100/upload Growth Opportunity: Work on meaningful programs with real impact Work-Life Balance: Regular schedule with reasonable expectations Location: Orange, CA Physical Requirements: Ability to sit, stand, walk, and use hands regularly Occasionally lift/move up to 10 lbs Visual acuity for reading and computer use Ready to take the next step in your career? Apply today and help us continue to make a difference in the lives of our members. Pay Range: $41,472.00 - $62,208.00 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 ******************.
    $41.5k-62.2k yearly Auto-Apply 7d ago
  • Vice President, Direct Network Strategy

    Alignment Healthcare 4.7company rating

    Sacramento, CA job

    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 Vice President of Direct Network Strategy is responsible for developing, executing and monitoring the strategic and tactical plans to implement a comprehensive Direct Network of primary care physicians and specialists across existing and expansion markets, with a primary focus in California. The Vice President of Direct Network Strategy will be responsible for implementing a scalable, value driven direct provider network that supports Alignment Health's goals for quality, cost effectiveness, access and member experience. **Remote - Anywhere in California** General Duties/Responsibilities (May include but are not limited to): Develop and Execute Network Strategy - Lead the overarching strategy to expand and optimize a high-performing Direct Provider Network to drive market growth and stability, with a focus in California. Drive Network Expansion - Accelerate the growth of the Direct Network across existing and emerging markets, ensuring geographic adequacy, clinical integration, and competitive positioning. Lead Contracting Strategy and Financial Performance - Implement diverse contracting methodologies, including shared savings and value-based programs, that incentivize quality, performance, and long-term provider partnerships. Manage the financial planning related to network costs and provider contracts, ensuring alignment with organizational goals. Strategic Leadership for Direct Network Recruitment - Lead and manage all aspects of Direct Network development, including executing market-specific strategies to identify, recruit, and contract with high-quality PCPs and specialists, as well as oversee onboarding and ongoing education to ensure effective integration and alignment. Procure Market Intelligence - Monitor industry trends, market dynamics, and regulatory changes to identify opportunities for Direct Network development, expansion and optimization. Enhance Provider Engagement - Foster deep and sustained engagement with the Direct Network providers through continuous relationship management and performance monitoring to build collaborative partnerships that drive growth. Build and Lead High-Performing Teams - Hire, mentor, and manage a team of network management and contracting professionals to support all Direct Network initiatives. Establish and Monitor Performance Metrics - Define and track key performance indicators (KPIs) and OKRs related to Direct Network recruitment, network adequacy, cost, quality, utilization, and provider engagement. Implement performance improvement plans, where needed, to support course correction to achieve targeted goals. Ensure Regulatory Compliance - Maintain compliance with federal, state, and contractual requirements, including network adequacy, access standards, and credentialing. Foster Cross-Functional Collaboration - Partner with regional GMs, Finance, Clinical, and Operations teams to align network strategies with broader market and organizational goals. Supervisory Responsibilities: Oversees assigned staff. Responsibilities include recruiting, orienting, and training employees; assigning workload; planning, monitoring, and evaluating job results; and coaching, counseling, and disciplining employees. 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: 10+ years of progressive leadership with experience in healthcare network strategy, value based provider contracting and Medicare Advantage. Familiarity with supporting primary care transformation and risk-bearing provider entities. Multi-market network development experience. Education/Licensure: Requires a Bachelor's degree in Public Health, Healthcare Administration, Business, or related field: Master's degree strongly preferred. Other: Strong knowledge of primary care dynamics, value-based care principles, and the role of PCPs in population health management. Proven track record of building and contracting with diverse provider networks, including engaging primary care providers and specialists across diverse markets and delivery systems. Experience with designing and implementing value-based care programs focused on quality, patient experience, and total cost of care. Exceptional leadership, negotiation, and relationship management skills. Demonstrated ability to work cross-functionally and lead in a matrixed environment. Strong data analysis, project management, and communication skills Experience working in or with health plans, provider organizations, or quality-focused healthcare settings in the Medicare Advantage space. Excellent oral, written and presentation skills Pay Range: $198,219.00 - $297,329.00 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 ******************.
    $198.2k-297.3k yearly Auto-Apply 6d ago
  • Scheduling Specialist

    Alignment Healthcare 4.7company rating

    Orange, CA job

    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 ******************.
    $41.6k-57.6k yearly Auto-Apply 6d ago
  • Key Account Executive

    Supercare Health 4.2company rating

    Industry, CA job

    “Improving the lives of those with chronic care diseases while providing solutions to our customers." Looking for a new opportunity? At SuperCare Health you have the chance to reach your dreams by helping us in serving the healthcare needs of our ever-growing patient population. Matching passion with careers, here hard work has never been so satisfying. *** Travel, as needed, to meet with partners/prospective partners*** Who We Are: SuperCare Health is the leading post-acute, in-home respiratory care provider in the Western U.S. that has been serving the healthcare needs of our ever-growing patient population for over 50 years. We specialize in respiratory and chronic disease management, delivering innovative solutions to enhance the quality of life for our patients. Our commitment to excellence has made us a trusted partner for healthcare providers across the nation. What We're Looking For: The Key Account Executive (KAE) supports SuperCare Health's growth and relationship strategy by serving as a field liaison and a primary administrative resource for Managed Care Organizations (MCO) and capitated partners. The role combines external sales outreach and account management with internal administrative and sales duties, ensuring seamless coordination between SuperCare Health and health plans, medical groups, independent Physician Associations (IPAs) and other referral sources. The KAE serves as a trusted advisor to providers, ensuring seamless coordination of durable medical equipment (DME) and respiratory care services while championing patient-centered care and market growth. What You'll Do: Sales & Business Development ● Develop and maintain relationships with MCOs, Medical Groups, IPAs and hospital systems to drive new contract and referral opportunities. ● Conduct field outreach and educational in-services to provider offices, hospitals, community health centers and other referral sources, promoting SuperCare Healths services and ensuring compliance with capitated agreements. ● Serve as liaison to capitated partners, ensuring orders adhere to capitation guidelines, and collaborating with UM teams for ongoing quality and compliance. ● Analyze healthcare and managed care industry trends, competitive conditions, and regulatory requirements to shape effective sales strategies. ● Administer and maintain HubSpot CRM data: Clean up records, update contact information, log touchpoints, generate performance reports, and monitor sales activity and referral trends. ● Manage Joint Operating Committee (JOC) meetings: schedule meetings, prepare agendas, collect and analyze data for discussions, distribute minutes and follow-up actions, and maintain as accurate meeting calendar for stakeholders. ● Support inside sales efforts by making outbound calls and emails to health plans, medical groups and IPAs; follow up on leads, set appointments, and respond to inquiries about services and contracts. ● Assist with preparing presentations, proposals and meeting materials for existing and prospective partners. Account Management ● Build and maintain long-term, consultative relationships with physicians, medical groups, hospitals, and office staff. ● Act as a Navigator within critical accounts to improve outcomes. ● Partner with Respiratory Account Executives to strengthen key account penetration and ensure quality of service. ● Coordinate with internal teams on plan escalations and JOC follow ups-including Customer Care Specialists, Dispatchers, and Respiratory Department. Operational Excellence ● Deliver outstanding customer service while balancing the needs of providers, patients, and payers. ● Ensure all pre-authorizations, billing documentation, and compliance requirements are met. ● Complete administrative responsibilities such as HubSpot clean up, JOC Schedules and Agenda/Slide prep, and timely communication via calls and emails. ● Share knowledge and best practices with colleagues to foster team collaboration and collective success. Patient & Provider Support ● Maintain consistent and professional interaction with patients, managed care groups, and medical teams to ensure seamless coordination of care. ● Demonstrate a patient-first mindset, with a genuine commitment to helping others and improving health outcomes. This role may be a fit if you have.. ● High school diploma required; higher education or certifications in healthcare/business preferred. ● Previous experience in Healthcare, DME, or Respiratory Sales strongly preferred. ● Strong knowledge of respiratory therapies (Ventilation, Vests, Oxygen, BiPAP, CPAP) and industry regulations. ● Proven track record in sales growth, account management, or business development. ● Exceptional communication, negotiation, and executive presentation skills. ● Ability to manage multiple projects in a fast-paced, high-pressure environment. ● Strong organizational skills with keen attention to detail and follow-up. ● Analytical problem-solving and critical thinking abilities. ● Professional presence, resilience, and adaptability to shifting priorities. ● Team-oriented, cooperative, and able to work independently with minimal direction. ● Compassionate, people-sensitive approach with a genuine desire to help patients. ● Active participation in professional healthcare organizations is a plus. Benefits: Medical Dental Vision Flexible Savings Account 401K Voluntary Life Insurance Observed Holidays: New Year's Day, Memorial Day, July 4th, Labor Day, Thanksgiving Day, Christmas Day. Perks: Paid Training Paid Time Off Sick Time Growth Opportunities Employee Referral Reward Program Employee Discount Program Any employment proposal is contingent upon satisfactory completion of: Background Check, Reference Check(s), Driving Record (if applicable), Pre-employment Drug and TB Tests What SuperCare Health is About "SuperCare Health is a comprehensive, post- acute care, respiratory services company, focused on managing high-risk respiratory patients in their homes. Today, SuperCare health manages millions of lives annually, with a growing team of more than 400 members, and has one of the highest-rated satisfaction scores from both our customers and patients. Our goal is to be the most trusted and preferred resource to manage high-risk, post-acute respiratory patients through our high-touch clinical team and high-tech, innovative solutions. Our end-to- end care solutions, from the hospital to the home, close gaps in care, reduce costs of care and improve outcomes. Our in-home services include ventilation, oxygen, CPAP/BiPAP, enteral nutrition, pharmacy services, and an expanding population health program. We are uniquely structured to be a responsive and agile community provider, yet we also possess the stability and effectiveness of a large enterprise. As a thriving business, our chief focus is on what really matters: reducing hospital re-admissions, optimizing outcomes and improving the lives of patients with chronic care diseases, every day.`` Connect With Us! Company Website **************************** Company Business Hours - 8:30 AM - 5:30 PM PST LinkedIn ********************************************** Twitter *********************************** Facebook ***************************************** Instagram ****************************************** Araceli Richardson - Jr. Recruiter LinkedIn
    $85k-135k yearly est. Auto-Apply 60d+ ago
  • Bilingual Spanish Health Coach and Educator (Conduct Home Visits in LA/OC, CA w/ Mileage Reimbursement)

    Alignment Healthcare 4.7company rating

    Los Angeles, CA job

    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 an organized, compassionate, and motivated bilingual Spanish Health Coach and Educator to join the interdisciplinary Care Anywhere team in Los Angeles / Orange County, California. As a Health Coach & Educator you will conduct home and virtual (telehealth and telephonic) visits to develop a wellness coaching relationship with patients, caregivers, and families through the process of actively working towards better health by providing support, encouragement, and education. - Must conduct between 6-8 home visits per day. - Mileage reimbursement provided from the time you leave home to the time you return. Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time GENERAL DUTIES / RESPONSIBILITIES: 1. Contacts patients that are eligible for Alignment's Care at Home program and provides necessary wellness coaching to reduce or eliminate high-risk behaviors 2. Collaborates with advanced practice clinicians and/or social worker to develop an action plan 3. Encourages adoption of habits that are conducive to a higher quality of life 4. Responsible for delivering a high level of patient service and increasing member retention and satisfaction 5. Assists patients with accessing community resources and social services to address social determinants impacting health and wellbeing 6. Develops and distributes health education materials to identified patients, caregivers, and/or families 7. Coordinates Care with other Alignment team members, including health-related vendors for optimal patient care Minimum Requirements: Experience: • Required: Minimum 1+ year of experience as a wellness or health coach or educator • Preferred: Senior care experience. Education: • Required: High School Diploma or GED. Associate's degree or two years additional experience in lieu of education. • Preferred: Bachelor's Degree Specialized Skills: • Required: Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Solid knowledge of specific diseases, lifestyle-related topics, nutrition, and exercise Knowledge of and experience with applying the stages of change or a similar behavior change model Excellent interpersonal skills with the ability to foster trust and respect among customers and coworkers. Able to work independently and remotely. Able to work with protected health information and maintain absolute confidentiality and privacy in accordance with HIPAA regulations and AHP policies Proficient computer skills including Microsoft Office Excel, Word and PowerPoint Ability to work a flexible schedule 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. • Preferred: Bilingual English and Spanish Licensure: • Required: Current and valid California Driver's License and reliable transportation. 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: $48,373.00 - $72,559.00 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 ******************.
    $48.4k-72.6k yearly Auto-Apply 35d ago
  • Internal Medicine Physician Leader - Fresno, CA

    Alignment Healthcare 4.7company rating

    Fresno, CA job

    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. Overview of the Role: The Regional Medical Officer is responsible for the clinical operations and all clinical financial outcomes within multiple markets. He or she will do this by maintaining and further improving Alignment's clinical model, improving medical outcomes and member satisfaction. The Regional Medical Officer will partner with the Regional Medical Officers, Vice Presidents, and other market leaders collectively to lead the start-up and champion the growth of new regions. Here are some of the benefits that you will enjoy: Yearly Bonus Restricted Stock Unit (RSU) Grant of at least 15% of annual salary Continuing education reimbursement up to $2000 per calendar year + 3 CME days Competitive PTO, 8 paid holidays and 1 Floating Holiday Medical, Dental, Vision 401k matching contribution up to 4% Paid parental leave Tuition reimbursement Responsibilities: Must be willing to do home visits 2 days a week Directly manage all Alignment employee physicians in the market of Fresno and Madera Counties Represent Alignment as the clinical leader of the market. Directly accountable for all clinical outcomes. Maintain a customer-driven passion for excellence and commitment to innovation and implementation of ideas that improve the healthcare of the patient population. Provide strategic and operational direction for the delivery of performance based medical management. Manage budget and risk drivers with regional vice president. Analyze and report business performance data to executive team and the Board of Directors. IPA Management and relationship holder in the assigned markets such as Allcare, Sante Physicians, Kova, etc. Conducting SNF rounds and management to at least one (1) SNF Utilization Management Oversight and assigned projects Participate/advise in the management of all the clinical divisions (physicians, NPs, PAs case management and MAs) within a single or multiple regions. Engage in the analysis of local profit and loss performance. Work seamlessly and effectively with the non-clinical departments within the organization. Develop and maintain strong relationships with providers and network. Hire, develop, and reward staff to effectively support the company's strategy. Supervisory Responsibilities: Responsibilities include: recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees. Direct staff of regional medical officers, physicians and other clinical management leaders. Preferred Skills and Experiences: 5+ years of Hospitalist, Family Practice, or Internist experience preferred but will also consider graduating residents and fellows. 3+ Years of Administrative Experience 3+ Years of Managed Care Experience Preferred Medical Doctorate (M.D.) or Doctor of Osteopathic Medicine (D.O.); Internal Medicine or Family Medicine Residency Medical License in the state in which you are applying; DEA license, must be board certified or board eligible in specialty. Career interest in management Spanish speaking Pay Range: $262,145.00 - $393,217.00 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 ******************.
    $262.1k-393.2k yearly Auto-Apply 6d ago
  • Manager, Utilization Management (Coordination)

    Alignment Healthcare 4.7company rating

    Orange, CA job

    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 Manager, Utilization Management (UM) Coordination, oversees non-clinical inpatient and pre-service operations under the direction of the Director of Utilization Management. This role provides leadership to UM Supervisors and their coordinator teams to ensure timely, accurate, and compliant processing of authorizations and referrals in accordance with CMS and organizational standards. The Manager drives operational efficiency, staff development, and process improvement while collaborating with internal departments to support continuity of care and overall service quality. Job Responsibilities: Provide operational leadership and direction to two Utilization Management Supervisors overseeing non-clinical coordinator teams supporting both Inpatient and Pre-Service workflows. Lead the teams meet established turnaround times (TATs), quality, and productivity standards for authorization processing, referral routing, and related UM functions. Oversee staffing allocation, scheduling, and workload balancing between inpatient and pre-service units to maintain consistent service levels. Conduct regular one-on-one meetings with supervisors to review performance metrics, workflow barriers, and staff development needs. Own the daily operations to ensure timely and accurate completion of authorizations, correspondence, and documentation in compliance with CMS, NCQA, and organizational standards. Identify process inefficiencies and implement corrective actions to improve turnaround, accuracy, and staff productivity. Lead root-cause analyses for escalated operational issues and coordinate corrective action plans. Responsible for all the accuracy of all UM workflows, systems, and reporting dashboards to support data-driven decision making. Oversee the development and delivery of training materials, competency assessments, and reference guides to promote consistent and compliant practices. Mentor Supervisors to build leadership capacity, coaching them on staff management, delegation, and performance improvement techniques. Drive onboarding, cross-training, and refresher sessions are regularly conducted to support staff versatility across inpatient and pre-service functions. Manage all team activities adhere to CMS and organizational policies related to Utilization Management, confidentiality, and member communication standards. Oversee internal audit reviews and collaborate with the Quality and Compliance teams to address findings and implement improvement plans. Direct that all letters and communications use approved templates and standardized language for UM determinations and continuity-of-care requirements. Participate in internal and external audits, Medical Services Committee meetings, and other regulatory reviews as required. Review and analyze key performance indicators (KPIs), including volume, turnaround time, accuracy, and productivity reports; present trends and improvement strategies to leadership. Support the preparation and submission of monthly UM reports, dashboard summaries, and Medical Services Committee deliverables. Leverage data to identify training needs, process gaps, and operational trends impacting service delivery or compliance. Serve as a liaison between UM, Case Management, Provider Relations, and Claims departments to streamline interdepartmental communication and issue resolution. Collaborate with network providers and internal teams to clarify authorization processes and ensure alignment with benefit and policy criteria. Participate in internal workgroups or initiatives to improve system functionality, workflow automation, and reporting enhancements. Assist with the development, implementation, and monitoring of UM-related initiatives and special projects (e.g., claims review process, continuity-of-care tracking, or performance optimization programs). Evaluate and revise UM policies and procedures to align with evolving regulatory standards and organizational goals. Support readiness activities for CMS audits and other accreditation requirements. Perform other related functions and special assignments as directed by senior leadership. Core Competencies: Leadership & Talent Development - Demonstrates the ability to lead through others by developing and empowering supervisors and staff. Fosters a culture of accountability, engagement, and continuous improvement within the UM department. Operational Management - Applies strong organizational and analytical skills to oversee workflow execution, resource allocation, and performance metrics across inpatient and pre-service teams. Regulatory & Compliance Expertise - Maintains in-depth knowledge of CMS regulatory standards, confidentiality requirements, and UM protocols to ensure full compliance and audit readiness. Analytical Thinking & Decision-Making - Uses data to identify trends, evaluate outcomes, and implement process improvements that enhance accuracy, turnaround times, and service quality. Communication & Collaboration - Communicates clearly across all organizational levels; partners effectively with Clinical Operations, Provider Relations, Case Management, and Claims to resolve issues and align priorities. Process Improvement & Innovation - Continuously evaluates operational workflows and implements efficiency strategies that support organizational goals and member satisfaction. Member & Service Orientation - Demonstrates commitment to delivering high-quality service, ensuring that UM processes support positive member experiences and continuity of care. Change Management - Adapts to evolving regulatory, system, and organizational needs while leading teams through process transitions and new initiatives effectively. Supervisory Responsibilities: Oversees assigned staff. Responsibilities include: recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and performance management. Job Requirements: Experience Required: Minimum (4) years of related experience in a managed care setting and a minimum (3) years of recent and related supervisory experience Education Required: Highschool Diploma or GED Required Preferred: Bachelor's Degree or higher Other: Strong knowledge of Medicare Managed Care Plans Proficient in Microsoft Word, Excel, and Outlook; advanced Excel skills preferred (pivot tables, formulas, data visualization, and reporting functions for performance tracking and analysis). Experience leading and sustaining process improvement initiatives within healthcare operations to enhance efficiency, compliance, and service quality. Communication and Interpersonal Skills - Excellent written and verbal communication skills; able to build and maintain collaborative relationships with diverse teams, including leadership, staff, and external partners. Analytical and Reasoning Skills - Strong analytical thinking with the ability to define problems, collect and interpret data, establish facts, draw valid conclusions, and develop actionable solutions. Problem-Solving and Organizational Skills - Demonstrated ability to prioritize multiple tasks, manage time effectively, and maintain accuracy in a fast-paced, dynamic environment. Data and Report Analysis - Ability to interpret, analyze, and present statistical and operational reports to support decision-making and performance monitoring. 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: $70,823.00 - $106,234.00 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 ******************.
    $70.8k-106.2k yearly Auto-Apply 49d ago
  • Utilization Management Coordinator

    Alignment Healthcare 4.7company rating

    Orange, CA job

    Utilization Management Coordinator 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: The Utilization Management (UM) Clerk will assist in the clerical support to the UM department staff (i.e. incoming/outgoing mail, data entry, filing, etc.) General Duties/Responsibilities: (May include but are not limited to) · Responsible for processing incoming and outgoing mail for the UM Department. · Maintains inventory of office supplies at a level necessary for proper functioning of the department. · Performs clerical duties deemed necessary to ensure smooth functioning of the department. · Performs data entry as requested. · Assist Inpatient team by entering Face Sheets and faxes. · Data integrity testing for new projects or project enhancement · Ensures delegated IPA/MGs provide CCHP with discharge dates, authorized days and discharge disposition on members assigned to delegated IPA/MG by faxing requests for information, tracking receipt of information and forwards information to Inpatient Team. · Call hospitals to obtain billing charges and maintain billing log. · Meets specific deadlines (responds to various workload by assigning task priorities according to department policies, standards, and needs). · Maintain Department miscellaneous filing in an organized fashion as well as create files as needed. · Recognizes work-related problems and contributes to solutions. · Maintains confidentiality of information between and among health care professionals. · Other duties as assigned by UM Management. 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. Minimum of one-year in clerical support. 2. Education/Licensure: a. High school diploma or general education degree (GED) b. At least six months related experience and/or training; or equivalent combination of education and experience. 3. Other: a. 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. b. 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. c. Typing speed 45 wpm and proficient use of 10-key calculator. d. Computer Skills: Microsoft Office. Knowledge of computer programs and applications required. e. Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. i. Excellent communication skills, oral and written. 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. i. The noise level in the work environment is usually moderate. 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 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. 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: Utilization Management Coordinator 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 ******************.
    $59k-72k yearly est. Easy Apply 60d+ ago
  • Respiratory Supervisor (TeleCare)

    Supercare Health 4.2company rating

    Industry, CA job

    “Improving the lives of those with chronic care diseases while providing solutions to our customers." Looking for a new opportunity? At SuperCare Health you have the chance to reach your dreams by helping us in serving the healthcare needs of our ever-growing patient population. Matching passion with careers, here hard work has never been so satisfying. Who We Are: SuperCare Health (SCH) is the foremost post-acute, in-home respiratory care provider in the Western U.S., dedicated to serving the healthcare needs of our expanding patient population for nearly 50 years. Specializing in respiratory and chronic disease management, we have earned our position as a leader in the industry by delivering innovative solutions that significantly enhance the quality of life for our patients. In addition to our well-established respiratory care division, we are proud to announce the launch of our Diabetes division, further expanding our comprehensive healthcare services. Our unwavering commitment to excellence has established us as a trusted partner for healthcare providers nationwide. Essential Duties: The Respiratory Supervisor is responsible for the general operation and leadership of all Chronic Care Programs managed under the TeleCare team. Responsibilities: Day to day supervision of TCT RT, Care Coaches, Sleep Coaches, and related outsourced entities Manage the processes and operation for all care management software, such as conducting training, providing necessary support, and help create clinical pathways and workflows related to implementation of care management software. Trains and supports staff as necessary, work collaboratively with the Clinical Operations Manager and Director of Respiratory Services to recruit, interview, and hire appropriate candidates for the TeleCare team. Responsible for team member's timesheets and monthly on call scheduling; assures completion of weekly call logs. Performs team member weekly reviews as well as monthly team meetings. Prepares and present data reports and plans of action to reporting Clinical Operations Manager and Director of Respiratory Services. Provides coaching and corrective action plans to employees under the supervision of the Clinical Operations Manager. Oversight of but not limited to RDT Process, TCT phone ques, Sleep Coach processes, PAP Unbilled Revenue, Clinical review processes, DF task management and Dept CFI responses Day to Day execution of CCM programs (C-19, iBreathe, NIV Plus, iAmStrong, iSleep) Supports purchasing escalations Provides alternative products or therapy options related to back orders Travel associated with team oversight, including but not limited to: Overnight travel Conference/Training seminar Out of state travel Works within developing software systems (i.e., Chronic Care Programs). Reviews all information for accuracy and completeness in regards to the enrollment of patients into all Chronic Care Programs and maintains program information on all patients with in the electronic documentation system and additional data base. Maintains equipment logs, and inventory. Schedules Interdisciplinary Care Team meetings, acts as a conduit to all members of the TCT, supports marketing department, and attend offsite trainings. When necessary responds to telephonic, electronic, and written inquiries from in house departments, care client staff including, care managers, and clinical staff. Responds to patient and family inquiries. Other duties as assigned. Qualifications: Education and/or Experience: Valid RCP License Valid RRT CA License High School diploma required. Three (3) years' experience of customer service or transaction processing in a Managed Care setting required. Medicare Advantage and Medicare Advantage Part D health plan with knowledge of enrollment activities preferred. Working knowledge of MS Office including Word, Excel, and Access with proficient typing skills. Understanding of Android and IOS systems. Other skills and experience: The ideal candidate will be Good leadership qualities and desire to coach the team Detail oriented and able to learn and follow policies and procedures Able to respond to common inquiries or problems in a professional manner, Able to handle heavy workload, and adapt to a high growth, rapidly changing environment Flexible, have good judgment, analytical skills and ability to work as a member of a team Able to work independently and to be organized in their work to ensure that tasks are completed in a timely manner. In possession of excellent communication skills and be professional when dealing with all aspects of the programs. Experienced in computer programs such as word, excel, Smart Sheet, Competency: (To perform the job successfully, an individual should demonstrate the following competencies): Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; works well in group problem solving situations; Uses reason even when dealing with emotional topics Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data. Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments. Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Participates in meetings. Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. Integrity - Treats people with respect; Keeps commitments; inspires the trust of others; Works with integrity and ethically; Upholds organizational values. Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; supports organization's goals and values. Creates and revises policies and procedures as needed. Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans. Capacity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly Initiative - Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Takes independent actions and calculated risks; Looks for and takes advantage of opportunities; Asks for and offers help when needed Benefits: Medical Dental Vision Flexible Savings Account 401K Voluntary Life Insurance Observed Holidays: New Year's Day, Memorial Day, July 4th, Labor Day, Thanksgiving Day, Christmas Day. Perks: Paid Training Paid Time Off Sick Time Growth Opportunities Employee Referral Reward Program Employee Discount Program Compensation DOE with a range of: $36.00- $56.70 hourly with a typical starting pay between $40.00 - $42.00 hourly Any employment proposal is contingent upon satisfactory completion of: Background Check, Reference Check(s), Driving Record (if applicable), Pre-employment Drug and TB Tests What SuperCare Health is About "SuperCare Health is a comprehensive, post- acute care, respiratory services company, focused on managing high-risk respiratory patients in their homes. Today, SuperCare health manages millions of lives annually, with a growing team of more than 400 members, and has one of the highest-rated satisfaction scores from both our customers and patients. Our goal is to be the most trusted and preferred resource to manage high-risk, post-acute respiratory patients through our high-touch clinical team and high-tech, innovative solutions. Our end-to- end care solutions, from the hospital to the home, close gaps in care, reduce costs of care and improve outcomes. Our in-home services include ventilation, oxygen, CPAP/BiPAP, enteral nutrition, pharmacy services, and an expanding population health program. We are uniquely structured to be a responsive and agile community provider, yet we also possess the stability and effectiveness of a large enterprise. As a thriving business, our chief focus is on what really matters: reducing hospital re-admissions, optimizing outcomes and improving the lives of patients with chronic care diseases, every day.`` Connect With Us! Company Website **************************** Company Business Hours - 8:30 AM - 5:30 PM PST LinkedIn ********************************************** Twitter *********************************** Facebook ***************************************** Instagram ******************************************
    $36-56.7 hourly Auto-Apply 60d+ ago
  • Manager, Member Engagement

    Alignment Healthcare 4.7company rating

    Orange, CA job

    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 ******************.
    $101k-126k yearly est. Easy Apply 60d+ ago
  • Veterinary Assistant - Urgent Care

    Mission Veterinary Clinic & Animal Emergency Hospital 3.8company rating

    Mission Veterinary Clinic & Animal Emergency Hospital job in Los Angeles, CA

    Job Description Join Our Team as a Veterinary Assistant - Urgent Care Make a difference in the lives of pets and their families every day! About Us At Mission Veterinary Clinic & Animal Emergency Hospital, we are dedicated to providing exceptional care to pets and peace of mind to their owners. Located in Granada Hills, CA, our clinic specializes in both routine and urgent care, ensuring every patient receives the attention they deserve. We pride ourselves on fostering a supportive and compassionate environment for our staff and clients alike. Position Summary We are seeking a skilled and caring Veterinary Assistant - Urgent Care to join our dedicated team. In this role, you'll work closely with our veterinarians and support staff to provide high-quality care to animals in need. If you have a passion for animal health and at least one year of experience in a veterinary setting, we'd love to hear from you! Key Responsibilities As a Veterinary Assistant - Urgent Care, you'll play a vital role in our clinic by: - Assisting veterinarians with exams, treatments, and procedures. - Monitoring and caring for pets during their stay, ensuring they are comfortable and safe. - Preparing and maintaining exam rooms, surgical areas, and equipment. - Communicating with pet owners, providing updates and compassionate support. - Handling administrative tasks such as patient records and scheduling as needed. Required Skills and Qualifications To succeed in this role, you'll need: - At least 1 year of experience in a veterinary assistant or similar role. - A genuine love for animals and a commitment to their well-being. - Strong communication and interpersonal skills to interact with both team members and pet owners. - The ability to work in a fast-paced environment, especially during urgent care situations. - A proactive attitude and attention to detail when handling tasks and patient care. Why Join Mission Veterinary Clinic? You'll be part of a team that values collaboration, compassion, and excellence in care. Every day brings new challenges and opportunities to grow, both personally and professionally, as you make a meaningful impact on the lives of pets and their families. Our Culture and Values At Mission Veterinary Clinic & Animal Emergency Hospital, we believe in treating every pet as if they were our own. Our team is passionate, hardworking, and dedicated to providing the highest standard of care. We foster a supportive work environment where everyone's contributions are valued, and we encourage continuous learning and growth. Ready to Join Us? If you're ready to take the next step in your veterinary career, we'd love to hear from you! Apply today and become a part of a team that's committed to making a difference-one pet at a time. By applying to this job, you agree to receive periodic text messages from this employer and Homebase about your pending job application. Opt out anytime. Msg & data rates may apply. Powered by Homebase. Free employee scheduling, time clock and hiring tools.
    $35k-43k yearly est. 4d ago

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