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:

Position Summary:

• Supervisors of Health and Wellness are responsible for providing day-to-day oversight of the Care Navigation, Assistant Health Coordination, Engagement Coordination and Front Desk Receptionist staff who are responsible to assist and coordinate medical services of members.
  • Medicaid Care Navigator have a caseload of up to 6000 low risk members and must ensure that Welcome Calls are initiated
  • Medicare Care Navigators complete initial and annual Health Risk Assessments (HRA), Medicare Care Plans and Interdisciplinary Care Team meetings according to regulatory requirements for low-risk DSNP membership.
  • Care Navigators also fields and coordinates any incoming clinical inquiries from members and providers
  • Assistant Health coordinators are responsible to assist in all non-clinician tasks for the Health Services teams of AlohaCare.
  • Engagement Coordinators are responsible for finding our Difficult to Engage (DTE) or Unable to Reach (UTR) members and getting them engaged with Primary Care Physician.
• Front Desk Receptionist coverage of day-to-day oversight and assistance of members, providers, vendor and public who visit Alohacare at our main office in Oahu at 1357 Kapiolani Blvd G101, Honolulu Hawaii. Supervisors of Health and Wellness must ensure Federal and State guidelines are followed and ensure that proper turnaround times are met.
• Supervisors of Health and Wellness will collaborate and work with others in the most efficient, accurate, and professional manner possible.
• This position requires the use of sound judgment and initiative to determine the approach or action for non-routine situations and when it is appropriate to escalate to upper management.

Primary Duties & Responsibilities:

• Ensure that the Care Navigators create and complete activities in an efficient and timely manner from date of enrollment.
• Ensure Assistant Health Coordinators create and completate activites in an efficient and timely manner.
• Monitor Care Management phone queue (ACD) to ensure timely response to incoming calls while minimizing abandoned calls.
• Provide support and training to Engagement Coordinators as needed while they are visiting shelters and/or attending AlohaCare promoted events.
• Ensure that Engagement Coordinators are attending in-field events to find members and get them engaged with AlohaCare and their Primary Care Physician.
• Ensure that the Assistant Health Coordinators supports the Health Services teams in an efficient and timely manner with non-clinical duties as appropriate.
• Monitor G8 actvities and letters to ensure Assistant Health Coordinators are meeting both internal and external turn around times per our Model of Care.
• Support Front Desk Receptionist daily interactions with members, providers, and vendors as needed.
• Ensure that Front Desk Receptionist maintains adequate supplies and housekeeping of suite G101.
• Plan and implement daily (as needed), weekly (recommended), and monthly (required) meetings utilizing both a team and individual setting with staff.
• Attend both internal and external meetings with intent to query or contribute any ideas or concerns pertaining to meeting topic.
• Plan and allocate resources for sufficient staffing to support the organizational strategic initiatives, departmental productivity, and quality goals.
• Share with teams any organizational initiative/goal, departmental initiative/goal, and/or team initiative/goal that has any effect on their job performance.
• Communicate, coordinate and/or train team members on any upcoming projects/events that will directly impact their daily job.
• Plan, evaluate, and improve the efficiency of business processes and procedures to enhance speed, quality, efficiency, and output.
• Establish and maintain relevant controls and feedback systems to monitor the operation specific to Care Navigators, Engagement Coordinators, Assistant Health Coordinators, and Front Desk Receptionist.
• Review performance data that includes financial cost savings, activity reports, and spreadsheets, to monitor and measure departmental productivity, goal achievement, overall effectiveness and process improvement opportunities.
• Assist with the preparation and maintenance of reports necessary to carry out the functions of the department.
• Prepares periodic and adhoc reports for management, as necessary or requested, to track strategic goal accomplishment
• Communicate regularly any trends and resource or staff performance issues to direct report, other managers and other designated contacts within the organization as needed and appropriate.
• Collobrates effectively with other departments, managers, or other designated contacts both within the organization and externally as necessary to improve departmental productivity and/or organizational strategic goals.
• Assist Manager in the consolidation of operational, budgetary, and financial responsibilities and activities of Care Navigators, Engagement Coordinators, Assistant Health Coordinators, and Front Desk Receptionist.
• Facilitate guidance on process changes mandated by regulatory bodies (Medicare/CMS, Medicaid/DHS), systems upgrade, and provide support of organizational performance audits and accredication surveys (NCQA).
• 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.
• Perform other duties and responsibilities, as assigned.

Required Competencies & Qualifications:

• Associate or Bachelor’s Degree or related job training and experience pertinent to the position
• 3-5 years of health plan experience with strong analytical skills
• Observed leadership competency with at least 1 year leadership experience in a health related field.
• Strong verbal and written communication in English
• Ability to organize, coordinate and supervise large projects in a timely, creative and effective manner
• Achieves results, builds trust, communicate effectively, customer and quality focused.
• Ability to multi-task, adapt to changing priorities, manage a diversity of high priority projects in a fast-paced environment
• Ability to problem solve, analyze, think critically, good judgment and make fair decisions.
• Proficient in Microsoft Programs; Word, Excel, Outlook and PowerPoint
• Available to work some afterhours work beyond normal office hours which may include evenings, weekends and holidays, as necessary.

Physical Demands/Working Conditions:

• Requires operation of computer workstation, including keyboard, mouse and video display terminal.
• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Salary Range: $60,000 - $73,000 annually

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.