Spanish Bilingual Complex Care RN
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Job Description
Complex Care RN coordinating virtual care for high-risk Medicare Advantage seniors at Alignment Health. Managing transitions, chronic conditions, medications, and quality outcomes.
Responsibilities:
- Manage and coordinate care for medically complex Medicare Advantage members
- Build trusted relationships with members and caregivers through ongoing virtual engagement
- Lead transitions of care following hospital, SNF, and inpatient discharges
- Complete medication reconciliations and monitor changes in clinical status
- Identify and escalate clinical concerns to the appropriate provider
- Partner with multidisciplinary teams to ensure seamless, coordinated care
- Support chronic disease management for heart failure, COPD, diabetes, and CKD
- Assist with HEDIS, quality initiatives, and care gap closure activities
- Maintain accurate, timely documentation in Athena EMR
- Collaborate with Advanced Practice Clinicians, Care Coordinators, Health Coaches, Social Workers, and Primary Care Providers within the Care Anywhere model
Requirements:
- Candidates must reside in the South Bay San Diego area
- Bilingual in Spanish and English (read, write, speak)
- Minimum 3 years of RN experience in complex care, care management, case management, transitions of care, palliative care, hospice, acute care, or a related clinical setting
- Experience managing medically complex, high-risk patient populations
- Experience with chronic disease management, medication reconciliation, and care transition coordination
- Experience in Medicare Advantage, managed care, home-based care, or value-based care environments
- Knowledge of HEDIS, HCC coding, and care gap management
- Experience working in telehealth or virtual care settings
- Strong interdisciplinary care coordination and communication skills
- Associate Degree in Nursing (ADN) required
- Active, unrestricted RN license in California
- Current BLS certification
- BSN or higher strongly preferred
- Certified Case Manager (CCM) certification preferred
- Multi-state RN licensure preferred
- Experience with Athena EMR and TalkDesk or similar virtual engagement platforms preferred
- Background in population health, care management programs, or Medicare case management preferred
- Ability to perform the stated essential physical functions, including frequently lifting and/or moving up to 10 pounds
Benefits:
- Ample room for growth and innovation
- Work at the top of your license supporting high-risk populations
- Innovative care model transforming senior healthcare
- Collaboration with a dedicated, multidisciplinary care team
- Direct impact on reducing hospitalizations and improving member outcomes
- Mission-driven organization focused on compassionate, coordinated care
- Reasonable accommodation may be made to enable individuals with disabilities to perform essential job functions
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