Bilingual Spanish RN Case Manager – Medicare Special Needs Program, Active California RN License Required

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $77.9k - $116.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

💬 Bilingual

👻 Ghost score 0%

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

🛡️ Insurance

🏥 Healthcare

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Coordinate care as a resource for members, families, and physicians • Ensure access to appropriate care for urgent or immediate needs by facilitating referrals and authorizations • Complete comprehensive assessments covering health status, resource utilization, treatment plans, and services • Collaborate with members, PCPs, and care teams to implement care plans • Interface with Primary Care Physicians, Hospitalists, Nurse Practitioners, and specialists on care-management treatment plans • Provide education and self-management support tailored to members’ learning styles • Assist with provider, claims, and service issues • Work with delegated or contracted providers, groups, and entities to ensure effective care coordination • Maintain confidentiality of protected health information in compliance with law and company policy • Reach out to and connect with members by telephone • Deliver care using the nursing process for members with complex and chronic care needs

🎯 Requirements

• Minimum 2 years' clinical experience • Minimum 1 year case management experience • Successfully passing post high school courses to obtain an RN licensure or AS in Nursing • Must have and maintain an active, valid, and unrestricted RN license in California (Non-Compact) • Immediately upon hire, must be willing to obtain LVN and/or RN licensure in Nevada (Non-compact), Arizona (Compact), North Carolina (Compact), and Texas (Compact) • High level of understanding of community resources, treatment options, home health, funding options, and special programs • Extensive knowledge of management of chronic conditions • Effective written and oral communication skills • Ability to operate PC-based software, including Word, Excel, and PowerPoint • Ability to perform mathematical calculations and calculate simple statistics • Ability to prioritize multiple tasks and use advanced reasoning to define problems, collect data, establish facts, draw conclusions, and manage resolutions • Effective problem-solving, organizational, and time-management skills • Ability to comprehend and analyze statistical reports • Must be willing to work 8:00am–5:00pm Pacific Time

🏖️ Benefits

• LVN and/or RN licensure in Nevada, Arizona, North Carolina, and Texas will be reimbursed by company • Equal Opportunity/Affirmative Action Employer