Unicare Community Health Center jobs in Los Angeles, CA - 58 jobs

Payroll/ HR Specialist is responsible for providing comprehensive support in the areas of payroll processing, human resources administration, and employee record management. The role ensures the accurate and timely execution of payroll activities, support all phases of the employee lifecycle (onboarding through offboarding) and helps maintain compliance with federal, state, and local employment laws and regulations. Duties/ Responsibilities Perform daily payroll department operations. Manage workflow to ensure all payroll transactions are processed accurately and timely. Reconcile payroll prior to transmission and validate confirmed reports. Understand proper taxation of employer paid benefits. Process correct garnishment calculations and compliance. Execute Ceridian Dayforce time and attendance processing and interface payroll. Perform compliances for unclaimed property payroll checks. Process accurate and timely year-end-reporting when necessary (W-2, W-2c, ect.) Oversee payroll transactions (e.g) via banking). Conduct regular audits on payroll procedures and records. Process benefit costs, like insurance fees and sick leaves. Design, document, and implement procedures to streamline payroll and human resources processes. Process manual check and support termination process and assist with processing of terminations. Update and reconcile monthly bank statements from CeridianDayforce Input and tracking of all employees' time off. Maintain employee information by entering and updating employment and status-change-data. Provides secretarial support by entering, formatting, and printing information; organizing work; answering the telephone; relaying messages; maintaining equipment and supplies. Maintains employee information by entering and updating employment and status-change data. Design maintains and updates spreadsheets or file indexes/cross-reference requiring data for reporting, timeliness and compliance purposes. This includes arching inactive records/files and updating new records/files for licenses, contracts, policies and other documents for the administration, the clinics and related partner organizations. Organizes and prioritizes daily workload by meeting deadlines, locates information, problem solves and contributes to solutions accurately and promptly. Report to management on payroll issues and changes. Manage timekeeping processes to support all payroll processing. Answer employees' questions about salaries and tax. Performs customer service functions by answering employee requests and questions, distributes payroll checks. Assists with the preparation of the performance review process. Ensure Unicare remains in compliance with all applicable laws and regulations as identified in the Corporate Compliance program and ensure proper reporting of violations to duly authorized enforcement agencies as appropriate or required. Stay up to date on state and federal payroll and tax laws. Review and maintain expense reports to obtain approval, enter Payroll Expense Report, route for further approvals. Submit employee data reports by assembling, preparing, and analyzing data. Maintains the accurate and up-to-date forms, integrity, and confidentiality of payroll, human resource files and records. Performs periodic audits of Payroll, HR files, and records to ensure all documents are filed appropriately. Coordinates special events such as benefits enrollment and 403(b) enrollments. Review changes/additions forms for 403(b) and coordinate payroll updates. Create all necessary forms for the office using Excel and Word. Completes Verification of Employment requests. Supporting Payroll and HR Department with day-to-day responsibilities. Prepare correspondence via email, MS Word and Adobe PDF. Assist recruitment process by tracking status of candidates, scheduling interviews, contacting references, providing employment paperwork to the hired candidates, preparing new hire folders, coordinate pre-onboarding drug screening, and physical exam as needed. Contributes to team effort by accomplishing related results as needed. All other duties, as assigned. Non-Essential Functions As directed by the Director of Human Resources, performs other related and/or necessary tasks to achieve organizational and programmatic goals and objectives. Professional Requirements Adhere to dress code, appearance is neat and clean. Maintain patient confidentiality at all times. Report to work on time and as scheduled. Maintain regulatory requirements, including all state, federal and local regulations. Represent the organization in a positive and professional manner at all times. Comply with all organizational policies and standards regarding ethical business practices. Communicate the mission, ethics and goals of the organization. Must have reliable transportation. Qualifications High School Diploma or GED required. Associate or Bachelor's degree in Accounting, Human Resources, Business Administration, or related field (required or preferred. HR or payroll certificate a plus (FPC, CPP, PHR or SHRM-CP) preferred. 2-5 years of experience in payroll processing and/or HR administration required. Experience with payroll systems such as Ceridian Dayforce preferred. Must be proficient in Excel, Word and Outlook. Familiarity with HRIS systems and timekeeping software. Experience managing benefits, onboarding/offboarding and employee records Knowledge, Skills and Abilities Excellent written and verbal communication skills. Extraordinary people skills with ability to communicate and cooperate at all levels of the organization. Ability to research with colleagues and effectively present information Strong customer service and relations-building skills. Management skills to interact with staff, providers, members and external agencies. Strong understanding of federal and state wage laws, tax regulations, and labor laws. In-depth knowledge of employee benefits and leave policies (e.g., FMLA, sick leave) Understanding of proper taxation of employer-paid benefits. Knowledge of HIPPA, and state/federal regulations related to payroll and HR. Ability to maintain confidentiality and adhere to UCHC privacy standards. Stay current with changes in payroll and employment laws and ensure compliance. Maintain a high level of understanding of health records and health information regulations. Strong organizational skills with keen attention to detail. Detail-oriented and highly organized. Demonstrated a strong work ethic and flexibility in daily responsibilities. Capacity to work independently and collaboratively. Maintains quality service by following organization standards. Contributes to team effort by accomplishing related results as needed. Maintains employee confidence and protects sensitive information. Travel Will be travelling to all Unicare Community Health Center clinic sites to work or attend meetings as needed. Physical Requirements and Environmental Conditions Pushing and pulling objects up to 25 lbs. Frequent wrist, hand and finger dexterity to perform fine motor function. Full range of body motion including twisting body, pushing, and pulling. Position requires light to moderate work with 25 lb. maximum weight to lift and carry. Position requires reaching, sitting down for long periods of time, walking, bending, stooping, and handling objects with hands and/or fingers, talking and/or hearing, and seeing. Work Schedule You will generally be scheduled to work each day Monday through Friday, with starting times each day varying between 8:00 a.m. and 9:00 a.m. and ending time between 5:00 p.m. and 6:00 p.m., as required to meet the operational needs of the company. There will be occasional Saturdays as needed. You will need to travel to other clinic locations as needed for cross coverage support. Working Conditions Non-Ionizing Radiation (microwaves, sun) Hazardous Exposure (chemical [E.G. Latex] and infectious) Our Mission The mission of Unicare is to be a community health care organization that treats everyone with dignity, respect and cultural sensitivity to help create an environment in which all can prosper.

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 ******************.

Field Sales Representative External Description: Field Sales Rep The Field Sales Rep position with Alignment Healthcare is responsible for generating leads to meet or exceed individual sales production of new enrollments and retaining existing members within company health plan(s). Must also build and maintain relationships with contracted providers and community affiliates within respective market(s) and/or assigned territories; including local area marketing. The Field Sales Rep reports to TBD and requires individual production activities on a daily/weekly basis that contribute to meeting or exceeding monthly sales, retention and lead goals in a defined territory or market(s). General Duties/Responsibilities: (May include but are not limited to) Responsible to meet or exceed monthly gross sales goal and retention of existing members. Service, build and maintain relationships with contracted providers and community affiliates within respective market(s) and/or assigned territories. Pursue grassroots efforts thru local area marketing to self-generated leads. Attend telemarketing blitzes as required by management. Submit daily activity production reports and/or monthly reports as required. Distribute CMS approved marketing materials to prospects, providers and community affiliates. Conduct group or one-on-one presentations to prospects, providers and/or local community affiliates. Understand new updates related to company and/or CMS and marketing guidelines required and be compliant with all CMS/Medicare and Alignment Healthcare guidelines. Attend ongoing sales trainings and best practices with team and other departments. Participate with competitor analysis (SWOTs) Strength, Weakness, Opportunities and Threats within respective market(s) and/or territories as required by management. Must be a team player, share best practices and attend staff meetings when required. Must possess strong time management and organization skills and abilities. Must possess a demonstrated ability to handle multiple tasks and responsibilities. Must be cross trained with call center capabilities to conduct telephonic enrollments, assisted telephonic enrollments, broker support assistance, field CMS secret shopping calls, participate with inbound/outbound campaign and/or quality assurance calls on an as needed basis. Other duties may be assigned as needed. Supervisory Responsibilities: This position has no direct employee supervisory responsibilities, however, the ability to collaborate and potentially work closely with our Network team, Member Services, Senior Ambassadors, Tele-sales colleagues to name a few is required. Minimum Requirements: Minimum Experience: Minimum of 2 - 3 years of general business to business, or business to consumer sales experience and/or clinical and/or community outreach and/or provider relations. Strong knowledge and understanding of the CMS Marketing Guidelines. Medicare knowledge and/or health insurance background preferred. Education/Licensure: Bachelor's degree preferred. Must have and maintain active Life & Health insurance license within respective selling state. Additional state licensure may be required as we continue to expand our footprint. Other: Must have a valid driver's license and reliable means of transportation to get to all sales activities and appointments. A self-starter who is a team player and extremely organized. Ability to motivate and educate providers, community affiliates, members and prospective members about company and health plan. Excellent public speaking and presentation skills. Solid computer skills (Word, Excel and PowerPoint). 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: Orange State: California Location City: Orange Schedule: Full Time Location State: California Community / Marketing Title: Field Sales 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 ******************.

Coordination of Benefit Representative External Description: The Membership & Eligibility Representative is responsible for the daily operations of both Eligibility and Membership Department. Provides Alignment Health Plan (AHP) internal departments, employee/partners and contracted providers in obtaining proper eligibility and membership data. Essential Duties and Responsibilities Essential duties and responsibilities include but are not limited to: Responsible for the reconciliation of all lines of business, as well as the CMS monthly files. Responsible to assist within both areas of membership and eligibility. This includes late enrollment penalty, disenrollments, out of areas, retros, third party submissions etc. Updating and deleting members other coverage through COB contractor via ECRS. Ensure members file is flagged with the proper coverage. (primary or secondary) Ensure all COB data is transferred into EZ-Cap. Responsible for surveying current members with other coverage on a yearly basis as well as new members. Collaborate with I.T. on creating reports and any system updates as per CMS guidelines. Responsible for meeting the regulatory compliance in all areas that affect the Eligibility and Membership. Answers the incoming phone calls within the goal marks set. Responsible for the daily, weekly, and monthly review and reporting of departmental queue stat reports to include Wrap-Up Code Reports, Resolution Contact Reports, and Agent Availability Reports. Ongoing clean-up of member data in all lines of business to ensure correct member information is provided to all systems and vendors. Meet specific deadlines. Responds to variations in daily workload by assigning task priorities according to department policies and standards. Ensure daily TRR is validated and all transactions are reviewed. Problem-solving process to resolve and/or mitigate those operational issues resulting in negative performance to plan as determined by the established escalation process. Will ensure that participation is made in the development and implementation of programs with direct effect towards the eligibility department. Participate in training programs and with the creation of materials for the day-to-day activity that is performed within the department. Will assist with creating department policies and procedures as needed to ensure the department is in accordance with CMS guidelines. Ensure all files are maintained in the shared drive. Submit monthly productivity reports to the Director. Assists with creating and implementing systems to improve workflows, tracking, reporting, and maintenance. Performs other duties as assigned. Supervisory Responsibilities There are no supervisory responsibilities. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. High school diploma required; BA preferred Minimum 2-5 years in a Health Maintenance Organization HMO or Medicare Advantage Prescription Drug Plan( MA-PD) preferred Must be familiar with CMS MMR and TRR files Chapter 2 Manage Care Strong sense of excellent customer service Strong written communication skills Proficient data entry skills Proficiency with Microsoft Office (Word, Excel, Access) Ability to complete tasks in a timely manner Strong organizational skills Ability to communicate effectively Good organizational skills Ability to prioritize Self-starter and able to work independently Excellent problem solving skills 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 uninvolved 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: Strong organizational skills. Good telecommunications skills. Attention to detail a must. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 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. The employee is frequently required to walk; stand; reach with hands and arms. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Working Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. City: Orange State: California Location City: Orange Schedule: Full Time Location State: California Community / Marketing Title: Coordination of Benefits 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 ******************.

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 ******************.

Appeals & Grievance 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. Summary The Appeals & Grievance Coordinator is responsible for the day to day functions of the tracking and trending of all grievances, appeals, and complaints received within the Member Services Department. The coordinator will act as the primary investigator and contact person for member and provider grievances and appeals. Essential Duties and Responsibilities (May include but are not limited to:) Will appropriately acknowledge the receipt of all grievance/appeals, and CTM (Complaint Tracking Module). Responsible for the gathering of all pertinent and relevant information from the member and/or provider regarding the grievance/appeal, determining the appropriate resolution of the grievance/appeal per standard policies and procedures; and notifying the appropriate parties of the resolution and ensuring that all internal processes are completed to resolve the issue. Compose written correspondence to members in accordance to plan policy and CMS Guidelines. Conduct non-biased, accurate, timely and comprehensive investigation of all the facts related to the grievance/appeal. Thoroughly document all action taken on behalf of the member or provider to resolve the grievance/appeal. Ensure that all grievances/appeals are processed in adherence to the Centers for Medicare and Medicaid (CMS) guidelines and plan policy. Prepare case files for Medical Director review and external (including IRE) review of grievances/appeals as appropriate. Prepare clear, objective, accurate and comprehensive case histories for presentation and consideration at committee meetings (including Board of Directors). Maintain accurate and timely documentation, including complete files of all grievances/appeals. Prepare monthly and quarterly reports as requested. Identify training opportunities and potential system and process improvements relating to grievance/appeal data. Participate in periodic review and update of grievance/appeal policies and procedures to reflect appropriate legal and CMS requirements as well as participate in periodic CMS Audit preparations and regulator meetings/interviews. Maintain a positive and professional relationship with plan staff, providers, members, and regulators. Other duties as assigned. Supervisory Responsibilities None. 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. Education and/or Experience: High school diploma or general education degree (GED) Certificates, Licenses, Registrations: None required. Other Qualifications: Knowledge of Medi-Cal or Medicare Managed Care Plans. Three to five years customer service experience. Two to three years of Appeals & Grievance preferred. Bi-lingual (English/Spanish) preferred. 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 uninvolved 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: Excellent communication skills. Excellent written skills Good telephone techniques. Excellent data entry. Strong organizational skills. Type 40+ words per minute. Experience with 10-key by touch. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 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. The employee is frequently required to walk; stand; reach with hands and arms. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Working Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. City: Orange State: California Location City: Orange Schedule: Full Time Location State: California Community / Marketing Title: Appeals & Grievance Coordinator (Temporary) 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 ******************.

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 ******************.

Regional Sales Manager External Description: Regional Sales Manager - Las Vegas, NV 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 Regional Sales Manager is responsible for the sales and growth of the broker channel and reports to Regional Director of Sales. The Regional Sales Manager oversees all channel activity including sales production, recruitment, training and sales strategy to grow the channel while maintaining a favorable acquisition cost for the company. General Duties/Responsibilities: (May include but are not limited to) In overseeing the broker channel, the Regional Sales Manager will: Create overall sales strategy for the independent sales channel Increase sales and meet or exceed sales expectations through existing active relationships. Recruit/build new selling relationships in existing markets and expansion markets to grow the broker sales channel. Manage provider relationships and assign agents to partner with Medical Groups/IPA's for growth. Oversee agent sales and product training including webinars for new agents, lock-in refresher trainings, and Open Enrollment recertification training. Assist with broker support channels including customer service calls and email inquiries. Monthly and ad-hok communications with external agents and agencies. Oversee interactions with external agents including commissions, discrepancies, enrollment kit fulfillment, certification and contracting/appointment requirements. Monitor quarterly agent and agency production requirements Ensure CMS compliance with all sales, enrollment processes and events Other duties and tasks may be assigned Supervisory Responsibilities: Oversee assigned broker support staff. Responsibilities include: recruiting, training employees; assigning workload; planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees. Training new team members on job description and duties. Ongoing: lead, motivate, coach and manage direct agents to ensure that performance goals are met and exceeded. Manager must be willing to commit to personal growth and be open to constructive feedback from direct reports and/or management. Must have proven ability to promote effective time management with self and direct team. Oversees compliance at all times to include secret shopping and ride-alongs Provides fair and objective documentation on corrective action plans and/or performance appraisals as directed by company policies and procedures. Provide effective and objective communication to keep team apprised of any updates and/or changes within department, CMS guidelines, company policies and procedures while keeping strong morale intact with team. Responds in an integral and timely manner with management and staff members in other departments to promote teamwork. Attends all mandatory management administrative, educational and/or training courses. Other supervisory responsibilities may be 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: Minimum of 3 years of general sales leadership experience. Minimum of 3 years of general sales experience and/or clinical and/or community outreach. Medicare knowledge and/or health insurance background preferred. Strong knowledge and understanding of the CMS Marketing Guidelines. Education/Licensure: Bachelor's degree preferred. Must have current and active life insurance license within respective selling state. Other: Must have reliable means of transportation to get to all sales activities and appointments. Extremely organized, detail driven and a self-starter. An innovator and effective leader with the ability to motivate direct team, community affiliates and provider relationships. Excellent public speaking and presentation skills. Exceptional computer skills (Word, Excel and PowerPoint). Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. 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: Regional Sales Manager Company Profile: Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time. By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community. EEO Employer Verbiage: On August 17, 2021, Alignment implemented a policy requiring all new hires to receive the COVID-19 vaccine. Proof of vaccination will be required as a condition of employment subject to applicable laws concerning exemptions/accommodations. This policy is part of Alignment's ongoing efforts to ensure the safety and well-being of our staff and community, and to support public health efforts. Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact ******************.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Member Experience Support Clerk is responsible for providing daily clerical support to the Member Ser-vices Department including but not limited to; the Member Services Representatives, Transportation Unit, Member Outreach Unit, and Appeals and Grievances Team. Job Duties/Responsibilities: Tracks incoming member correspondence in the department mail log & EZ Member database. Assigns a MS Representative as appropriate for follow up including “Request for Assistance” forms from the Sales/Marketing Dept daily. Tracks the incoming Health Risk Assessment Surveys into the EZ Member database and logs all HRA Vitamin Coupons. Maintains the departments miscellaneous filing in an organized fashion and create files for new staff as needed. Maintains the inventory of department supplies (ID Card Stock, PCP Change Forms, ID Card Holders, Birthday Cards, Transportation Postcard Reminders, etc.,) and orders supplies as needed. Maintains daily, monthly department mailings including but not limited to, birthday cards, anniversary cards, condolence cards, and miscellaneous mailings. Acknowledges and logs the receipt of all grievances, appeals, and CTM (Complaint Tracking Module). Provides clerical support to the Appeals and Grievance Coordinator. Assembles, maintains & protects member A&G case files in an organized fashion. Faxes grievance response requests to appropriate parties for the gathering of all pertinent and relevant information from the provider regarding the grievance/appeal. Provides follow up calls to providers and/or IPA and members as appropriate to ensure compliance with timelines set forth to ensure CMS compliance. Logs point of contacts of providers and/or IPA and members. Performs other duties clerical or otherwise as assigned by the Department Manager. Supervisory Requirements: None. Job Requirements: Experience: • Required: Minimum 1 month of related experience and/or training; or equivalent combination of education and experience. • Preferred: None. Education: • Required: High School Diploma or GED. • Preferred: None. Training: • Required: None. • Preferred: None. Specialized Skills: • Required: Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans. Bilingual (English/Spanish) required. Basic Computer Skills, 30 WPM (Microsoft Outlook, excel, word). 10-Key by Touch. 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. 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. Licensure: • Required: None. • Preferred: None. 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 ******************.

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. This position is responsible for identifying, analyzing, and helping with remediate security vulnerabilities within our applications. This role requires a strong understanding of application security principles, hands-on experience with various security testing methodologies, and excellent communication skills to collaborate effectively with development teams and other stakeholders. Job Responsibilities: Conduct static application security testing (SAST), dynamic application security testing (DAST), and interactive application security testing (IAST) on a continuous basis. Identify, triage, and validate security vulnerabilities using both automated tools and manual review. Work closely with software development and DevOps teams to provide clear, actionable guidance on how to fix vulnerabilities and implement secure coding practices. Help integrate security controls and checks into the software development lifecycle (SDLC) and CI/CD pipelines. Drive and support application security reviews and threat modeling. Manage and configure a suite of application security tools, ensuring their effective use and reporting. Stay up-to-date with the latest security threats, trends, and technologies, and conduct research on new vulnerabilities and attack vectors. Contribute to the creation and maintenance of application security policies, standards, and procedures to guide development teams and ensure compliance. Develop and deliver security awareness and secure coding training to engineering teams. Support and lead third-party penetration testing. Job Requirements: Experience: Required: 5-7+ years of progressive experience in information security, with a strong focus on application security testing and vulnerability management. Proven track record of working directly with developers and engineering teams to identify and remediate security vulnerabilities in a fast-paced environment. Experience in a large-scale enterprise environment with complex application portfolios. Preferred: Experience in healthcare or another highly regulated field. Education: Required: Bachelor's degree or equivalent work experience in Computer Science, Information Security, or a related technical discipline. Preferred: Relevant professional certifications such as Offensive Security Certified Professional (OSCP), GIAC Web Application Penetration Tester (GWAPT), or Certified Secure Software Lifecycle Professional (CSSLP) are highly desirable. ISC2 Certified Information Systems Security Professional (CISSP) Specialized Skills: Required: Experience with general threat hunting techniques and tools. Experience with one or more programming languages (i.e., C#, Scala, Python). 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: $113,332.00 - $169,999.00 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 ******************.

We are looking for a detail-oriented Optometric Assistant to perform customer service, clerical, and technical services to assist the Optometrist. The Optometric Assistant's customer service responsibilities include greeting customers, answering questions, and assisting customers to choose frames. Clerical responsibilities include scheduling appointments, documenting patient histories, filing insurance claims, and maintaining inventory. Technical responsibilities include taking visual acuity measurements and measuring the distance between the patient's pupils. To be a successful Optometric Assistant, you should have strong organizational and communication skills. You should demonstrate a strong attention to detail, and a good working knowledge of optical equipment and its uses. RESPONSIBILITIES: Greeting customers, answering questions, and obtaining preliminary patient histories. Performing administrative duties, such as keeping records, scheduling appointments, filing insurance claims, performing bookkeeping, and managing inventory. Preparing patients for vision examinations, such as administering eye drops and seating patients at eye-testing machines. Assisting with vision examinations, such as performing depth and color perception tests and taking visual acuity measurements. Assisting customers with frame selections. Working with patients in vision therapy, and educating patients on proper eye and contact lens care. Adjusting and repairing frames, and modifying contact lenses. EDUCATION AND REQUIREMENT: A high school diploma or equivalent. An Associate's degree in medical assisting may be a benefit. An Optometric Assistant Certification may be a benefit. Excellent organizational, communication, and interpersonal skills. A strong attention to detail. The ability to multi-task. The ability to work with delicate tools and materials. WORK HOUR Monday-Friday 9am-6pm, Saturday 9am-3pm. Part or all of an 8 hour shift

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 ******************.

To provide consultation, diagnosis and treatment of related medical conditions, under supervision of Women's Health Director. Essential Functions Conducts exams on Ob/Gyn patients, takes medical history, records results, and makes preliminary diagnosis or decides on follow-up procedures. Administers or orders diagnostic tests, blood work, and interprets test results. Review preventive health needs with patients. Performs Gyn procedures such as IUD insertion and removal, Nexplanon insertion and removal, colposcopy, etc. Manage Ob/Gyn patients through the perinatal period, including: Confirming/dating pregnancy Educating on pregnancy health Performing Ultrasounds Monitoring fetal activity Address infertility concerns as required. Prescribes medications to the extent allowable by state guidelines and clinic regulations. Provides health education regarding health maintenance especially in the realm of STD prevention. Provide sexually transmitted disease diagnosis, treatment, and education. Educate on available contraception and birth control options. Prescribe medications and contraception. Provide menopause education and counseling. Screen for domestic violence, substance abuse, and high-risk behaviors. Diagnosing female-related disease processes including: Breast, ovarian, cervical cancer Hormone changes/menopause Ovarian cysts Female infertility Urogynecological disorders Prescreens cases requiring review by the Women's Health Director and/or Medical Director. Non-Essential Functions As directed by the Women's Health Director, performs other related and/or necessary tasks to achieve organizational and programmatic goals and objectives. Professional Requirements Required to have the ability to deal effectively with a diversity of individuals at all organizational levels and with external customers. Adhere to dress code, appearance is neat and clean. Maintain current Nurse Practitioner license, BLS certification. Maintain patient confidentiality at all times. Exercises professional judgment regarding consultation with Women's Health Director concerning appropriate treatment. Participates in staff meetings, planning meetings and other meetings as needed. Participates in the program's ongoing quality assurance monitoring. Professional Requirements (Continued) Exporting date for Ob patients to make sure all entries are properly documented. Maintain regulatory requirements, including all state, federal and local regulations. Represent the organization in a positive and professional manner at all times. Comply with all organizational policies and standards regarding ethical business practices. Communicate the mission, ethics and goals of the organization. Participate in performance improvement and continuous quality improvement activities. Attendance and punctuality are necessary. Ability to work well with a multidisciplinary team. Ability to problem solve and be self-motivated. Able to work independently with little or no supervision. Must have a commitment to excellence and high standards. Must have excellent written and oral skills, strong organizational, problem-solving and analytical skills. Must have ability to multitask, manage priorities and workflow. Required to have versatility, flexibility and a willingness to work within constantly changing priorities with enthusiasm and have acute attention to detail. Able to operate computer software with training. Expected to have strong interpersonal skills and have the ability to understand and follow written/verbal instructions. Excellent verbal and written communication skills, including strong organizational and interpersonal skills; Demonstrated ability to work effectively with men and women of diverse races, ethnicities, ages, and sexual orientations in a multicultural environment. Qualifications Minimum of two (2) years Ob/Gyn experience preferred; Thorough knowledge of principles and practices of modem medicine related to public health services; general knowledge of state and federal laws pertaining to public health; Knowledge of EHR and Microsoft Office Training, Education and Licensure Current and unrestricted license to practice medicine in the state of California Active AANP Certification DEA Certification Current BLS certification. Knowledge, Skills, and Abilities Excellent patient care and time management skills Ability to work independently and without direct supervision Flexible, strong multi-prioritizing skills and time management skills. Demonstrate the skills to provide age-appropriate care to the clients of the clinic. Develops and implements patient care plans, instructs and counsels patients and records progress. Design treatment plans. Demonstrate knowledge of the principals of growth and development over the life span and possess the ability to interpret information relative to the patients age related needs. A comprehensive knowledge of primary care in outpatient settings. Excellent people skills, with an ability to partner with a dynamic leadership team. Possess personal qualities of integrity, credibility, and commitment to corporate mission. Flexible and able to multitask; can work within an ambiguous, fast-moving environment, while also driving toward clarity and solutions; demonstrated resourcefulness in setting priorities. Supervise nurse practitioner students, medical assistants and volunteer Ob/Gyn health workers. Travel Occasionally will be travelling to other clinic sites to work or attend meetings. Physical Requirements and Environmental Conditions Exposure to blood and body fluids, communicable diseases, chemicals, radiation, and repetitive motions Pushing and pulling objects up to 25 lbs. Frequent wrist, hand and finger dexterity to perform fine motor function without tremor. Full range of body motion including twisting body, pushing, pulling Position requires light to moderate work with 25 lb. maximum weight to lift and carry. Position requires reaching, bending, stooping, and handling objects with hands and/or fingers, talking and/or hearing, and seeing. Working Conditions Non-Ionizing Radiation (welding flash, microwaves, sun) Hazardous Exposure (chemical [E.G. Latex] and infectious) Work Schedule Report to work on time and as scheduled. Scheduled to work 40 hours per week. Must be available to work at least every other Saturday. May be traveling to all Unicare Health Center clinics to work or attend meetings as needed.

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 ******************.

Accounting Coordinator External Description: Testing City: Anaheim State: California Schedule: Full Time Community / Marketing Title: Accounting 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 ******************.

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 ******************.

This associate clinical social worker will provide mental health and related services in a manner that upholds Unicare Community Health Center's mission to improve the health status and well-being of underserved segments of the population in the communities we serve through the direct provision or coordination of health care, health education, and services. This includes interviewing, treating, coordinating, planning and linkage to a full range of resources that meet practical, social and emotional needs, in collaboration with a multidisciplinary team and community and community-based programs. As a result, patient outcomes and satisfactions are improved, along with organizational fiscal capacity. Duties/Responsibilities: Conducts clinical interviews to gather information, assess patient needs, determine the appropriate need, and develop diagnostic information. Maintains accuracy, completeness and timeliness with medical charts. All medical charts must be closed with 48 hours of the encounter In order to ensure high standards of care and compliance with regulatory requirements. Provide short-term, structured, evidence-based psychotherapy and counseling as part of a treatment plan. Provides Clinical therapeutic services to patients across the lifespan, including individual and group therapy and coordination of treatment for participants with co-occurring disorders. Provide crisis intervention as needed in different clinics. Participate in the development of patients' individualized care plans, in a timely and thorough manner. Provide treatment to assigned patients within the scope of practice, meeting program/department productivity and quality standards. Coordinates and collaborate with Primary Care Providers, Behavioral Health Coordinator, Case managers, Substance Abuse Counselor, Medical Director of Behavioral Health, Chief Medical Officer and other Staff to improve health outcomes. Facilitates referrals to other services and allied agencies as needed. Works closely with Unicare's Psychiatrists and other Clinicians when needed. Meets patient needs effectively and resolve individual barriers through follow-up, advocacy, and collaboration with other staff and community service providers. Serves as a mandated Child Protective Services (CPS) and Adult/Elder Abuse reporter. Maintains accurate and timely records of activities, case management notes, and services provided to each patient. Facilitates and participates in chart reviews and audits of behavioral health clinicians. Completes paperwork to support mental health billing in a timely manner. Attends and participates in a variety of internal and external meetings. Performs related duties as assigned. Is engaged and facilitates outreach initiatives Proactively utilize clinical supervision and/or peer consultation Provide direct behavioral health and medical social work services to Latino individuals, families, groups and communities, under the supervision of the Director of Behavioral Health. Provide crisis counseling as needed and outreach counseling to community settings such as schools, home visits, and other settings as assigned by the Director of Behavioral Health. Participate in weekly case review meetings. Supply court psycho-social evaluations, give reports of attendance and make court appearances when necessary. The clinician will refer clients to supportive community services and in-house medical services or support programs to supplement office treatment and counseling. Adheres to accreditation and compliance standards/guidelines and gets yearly cultural supportive training. Periodically provide community mental health presentations and power point presentations on pain management, childhood mental health issues, or stress management workshops to the community or Unicare staff. Non-Essential Functions As directed by the Director of Behavioral Health, performs other related and/or necessary tasks to achieve organizational and programmatic goals and objectives Professional Requirements Adhere to dress code, appearance is neat and clean. Maintain current license, registrations and/or certifications. Maintain patient confidentiality at all times. Report to work on time and as scheduled. Maintain regulatory requirements, including all state, federal and local regulations. Represent the organization in a positive and professional manner at all times. Comply with all organizational policies and standards regarding ethical business practices. Initials Communicate the mission, ethics and goals of the organization. Participate in performance improvement and continuous quality improvement activities. Qualifications Associate Clinical Social Worker (ACSW) registration and number issued by the California Board of Behavioral Health Master's degree in Social work required. Two years of experience in medical social workpreferred. Knowledge of social work professional code of ethics and values Bilingual English/Spanish strongly preferred. Knowledge, Skills, and Abilities Requires a comprehensive knowledge of behavioral health in outpatient settings. General knowledge of behavioral health counseling skills, including the ability to perform biopsychosocial assessments, crisis prevention, supportive therapy, and coping skills development. Knowledge and ability to find resources for patients and the ability to link and refer patients as needed. General understanding of the most recent diagnostic manual. Excellent people skills, with an ability to partner with a dynamic leadership team. Knowledge of providing culturally competent services to a variety of diverse patients. Possess personal qualities of integrity, credibility, and commitment to corporate mission. Flexible and able to multitask; can work within an ambiguous, fast-moving environment, while also driving toward clarity and solutions; demonstrated resourcefulness in setting priorities. Maintain current knowledge of policies and procedures as they relate to safe work practices. Follow all safety procedures and report unsafe conditions. Ability to work with a diverse population. Willing to work flexible hours, including evening and/or weekends. Must have reliable transportation. Must be self-directed and work productively with minimal supervision. Ability to work effectively as a member of an interdisciplinary team Demonstrated proficiency in using Microsoft applications such as Word, Excel, Access, Outlook Knowledge of Electronic Health Records Physical Requirements and Environmental Conditions Prolonged periods of sitting and working on a computer. Pushing and pulling objects up to 25 lbs. Frequent wrist, hand, and finger dexterity to perform fine motor function. Position requires light to moderate work with 25 lb. maximum weight to lift and carry. Full range of body motion requires twisting body, pushing, pulling, reaching, bending, stooping, and handling objects with hands and/or fingers, listening, talking, and/or hearing, and seeing. Working Conditions Non-Ionizing Radiation (microwaves) WORK SCHEDULE Monday - Friday: with starting times each day varying between 8:00 am and 9:00am and ending at 5:00 pm and 6:00pm. May travel to all Unicare Community Health Center clinics to work or attend meetings as needed.

Clinical Education, Director APC 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. The Alignment Care Anywhere program is a physician-led and advanced practice clinician-driven program that is intended to care for and support Alignment Healthcare patients by proactively providing an additional level of medical and social support via various modalities, including in the comfort of their home, Alignment Clinic, or telehealth visits. This program provides patients with medical and social support when and where they need it, with the goal of preventing unnecessary hospitalizations, health complications, and unmanaged disease progression that can occur when timely clinical interventions are not provided or are not accessible. Our clinic, home-based, and telehealth programs are offered to eligible patients at no cost to them. Position Summary: In collaboration with the Care Anywhere (CAW) Clinical Leadership Team, the Clinical Education Director provides clinical education, evaluation, and systems training to new and existing clinical staff, including Nurse Practitioner, Physician Assistant, and Physicians and is responsible for superior clinical outcomes for the Care Anywhere Program. We believe that the best clinical trainers continue to provide patient care which allows them the ability to test, edit, and optimize workflows, so this position will require maintaining a smaller patient panel assignment. General Duties/Responsibilities: (May include but are not limited to) In collaboration with the Clinical Education Director, is responsible for new hire onboarding and training of Nurse Practitioners and Physician Assistants. Provides educational leadership to patients and care providers to enhance specialized patient care within established clinical protocols. Works closely with Physicians, Nurse Practitioners and Physician Assistants to ensure that they know how to appropriately use the Patient 360 Form to help guide clinical focus and improve clinical documentation. Collaborates with medical providers and patient care staff in the planning, implementation, and delivery of educational curriculum. Will spearhead and develop initial onboarding educational content as well as ongoing training to provide refresher training and new content Will develop a year-long training schedule that will focus on key topics and clinical training protocols to be reviewed on a monthly, quarterly, and annual basis for new and established providers. Initiates clinical skills development programs within the parameters of established clinical and preceptorship models; monitors trends and implements educational strategies to ensure compliance with quality standards and parameters. With direction from CAW Clinical Leadership Team, this position supports the clinical team based on policies and procedures that conform to current standards of practice, company philosophy, and operational policies while maintaining compliance with state and federal laws and regulations. Works closely with AHC clinical leaders, regularly discussing any concerns regarding utilization of services or complicated cases. Educates technical and patient care staff in the use of new equipment, supplies, and instruments; coordinates in-service training and workshops for appropriate staff. Ensures proper care in the use and maintenance of equipment and supplies; promotes continuous improvement of workplace safety and environmental practices. Responsible for retention of current clinical team and working proactively with CAW leadership to help support and mentor NPs and PAs. Will report all findings to the CAW Clinical Leadership Team or appropriate company executive for final decision. Performs direct patient care 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: 5+ years related experience with clinical emphasis for Nurse Practitioner or Physician Assistant; or any combination of education and experience, which would provide an equivalent background. Minimum of 1-year experience leading clinical staff, preferably within a high-risk clinic and/or home-based care delivery environment Current unrestricted state license and current state driver's license Knowledge of CPT, ICD-9 and HCPC codes Knowledge of clinical standards of care Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems, is helpful Passion for geriatric patient care Comfortable with providing home-based care/home visits Ability to travel up to 50% local and nationally Ability to manage multiple new-hires and prioritize training needs Ability to work independently to meet company goals and timelines Strong interpersonal and technical presentation skills Skilled in identifying and resolving problems Proficient at verbal and written communication Detail oriented and accurate Demonstrated compatibility with Alignment's mission and operating philosophies Demonstrated ability to read, write, speak, and understand the English language Knowledge of related accreditation and certification requirements. Ability to assess educational needs and design and develop training content and material Working knowledge of the use of established clinical and preceptorship models in the development of clinical education programs. Ability to plan, implement, and evaluate individual patient care programs. Highly developed verbal and written communication skills and the ability to present effectively to small and large groups. Strong interpersonal skills and ability to work effectively at all levels in a collaborative team environment. Intermediate-level computer proficiency including Outlook, EMR- AllScripts and EPIC, and equipment such as iPad, and iPhone Supervisory Responsibilities: None Education/Licensure: Master's Degree or higher in Nursing OR Graduate of an accredited Physician's Assistant program required. Current unrestricted RN license and NP license in applicable state OR PA license in applicable state and current NCCPA certification required. Prescribing authority/DEA licensure in good standing as required in the state in which you are applying preferred. Other: EMR experience is strongly preferred. Must be able to work a flexible schedule and travel as needed. Preferred: Experience in gerontology, adult care Home care or home visit experience Excellent administrative, organizational, and verbal skills Effective communication skills with seniors Ability to work independently Detail-oriented Dependable and reliable Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. 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: Clinical Education, Director (APC) 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 ******************.

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 ******************.