Bilingual Remote Complex Care RN – San Diego

Alignment Healthcare USA, LLC in; Orange (CA); Remote; USD 86,000 - 129,000; Full time

Job summary

Alignment Health in San Diego County is seeking a Complex Care RN to coordinate care for high-risk Medicare Advantage members using virtual engagement and Athena EMR. You will lead transitions of care, reconcile medications, and collaborate with multidisciplinary teams to improve outcomes and quality of life.

Requirements include at least 3 years of RN experience in complex or related settings, bilingual English/Spanish, active CA RN license, ADN or BSN preferred, and experience with telehealth.

Qualifications

• Minimum 3 years of RN experience in complex care, care management, case management, transitions of care, palliative care, hospice, acute care, or related clinical setting.
• Bilingual English/Spanish
• Experience with Medicare Advantage, managed care, home-based care, or value-based care environments.

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 elevate clinical concerns to the appropriate provider.
• Partner with multidisciplinary teams to ensure seamless, coordinated care.
• Support chronic disease management for conditions including heart failure, COPD, diabetes, and CKD.
• Assist with HEDIS, quality initiatives, and care gap closure activities.
• Maintain accurate, timely documentation in Athena EMR.

Skills

RN experience

Care management

Transitions of care

Telehealth experience

Bilingual English/Spanish

Education

Associate Degree in Nursing (ADN)

BSN preferred

Active CA RN license

Tools

Athena EMR

TalkDesk

Job description

Alignment Health in San Diego County is seeking a Complex Care RN to coordinate care for high-risk Medicare Advantage members using virtual engagement and Athena EMR. You will lead transitions of care, reconcile medications, and collaborate with multidisciplinary teams to improve outcomes and quality of life.

Requirements include at least 3 years of RN experience in complex or related settings, bilingual English/Spanish, active CA RN license, ADN or BSN preferred, and experience with telehealth.