Apply on line at http://www.alohacare.org/Careers/Default.aspx

The Company:

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.

The Culture:

AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication, and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect, and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

The Opportunity:

Job Summary:

The Health Coordinator is responsible for conducting face-to-face assessments, developing individualized health action plans, interacting with members, providers, and physicians to coordinate primary, acute, behavioral, and long-term services and supports (LTSS) for individuals having special health care needs. Job functions are performed in accordance with requirements of the QUEST Integration contract and health plan goals and quality outcome metrics.

Primary Duties and Responsibilities:

• Conducts face-to-face or virtual (video chat) Level of Care Assessment (DHS Form 1147) for members needing long term care.
• Meets with the member at a minimum every 90 days in person or via video chat to monitor and document the Member’s progress in the Health Action Plan.
• Verifies authorized or coordinated services have been provided.
• Reports any concerns about service delivery or providers.
• Interacts with member, family, physician(s), and other providers utilizing clinical and social knowledge and expertise to gather information that will assist the Health Coordinator in determining the member’s level of care.
• Screen potential Health Coordination members for eligibility.
• Screens for social risk factors and incorporate information on the results of positive screens into clinical decision making and offer screened members interventions to mitigate the impact of social risk factors, including timely referrals with positive screens.
• Ensures compliance with all state and federal regulations, including HIPAA standards of confidentiality of protected health information, reporting of critical incidents, and reporting of quality-of-care issues.
• Performs other duties as assigned.

• Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules, and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Required Competencies and Qualifications:

• Experience with serving members in the community
• Health plan experience with care coordination responsibilities
• Experience with Medicare / Medicaid programs

• Experience with individuals who have special health care needs, including: HIV/AIDS, developmental disabilities, medically-fragile, older adults, and individuals with physical disabilities
• Prior nursing home diversion or long term care case management experience serving members in the community
• Previous experience in utilization management, discharge planning and/or home health or rehab
• Intermediate computer skills and experience with Microsoft Office products
• Must be organized and detail-oriented
• Must possess strong written and verbal communication and presentation skills

Required Licensure/Certification/Education:

• Associate’s degree in Health Care Administration, Nursing, Long Term Services and Supports, Public Health, or related field
• Licensed RN, in the State of Hawaii

Preferred Qualifications:

• Bi-lingual in any of the following languages preferred: Ilocano, Tagalog, Mandarin Chinese, Japanese or Korean
• Ability to communicate using American Sign Language

Physical Demands/Work Environment:

• Medium work: Walking, standing, and exerting up to 40 pounds of force occasionally, or up to 25 pounds of force frequently, or greater than negligible up to 10 pounds of force constantly to move objects.
• May require prolonged sitting up to 4 hours.
• Requires operation of a computer workstation, including keyboard and video display terminal.

Salary Range: $38.00 - $40.00 an hour

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with

sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans’ status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.