Bilingual RN Care Coordinator (Spanish)

Evry Healthcare Inc.; United States; À distance; USD 80 000 - 90 000; Plein temps

Avantages offerts par ce poste

Remote work

Résumé du poste

Evry Health Inc. is seeking an RN Integrated Care Coordinator to deliver comprehensive care coordination for our fully insured commercial population.

This remote role emphasizes proactive member engagement, individualized care planning, and utilization review support in a technology-forward environment. You will develop care plans, educate members and providers, and document all activities while promoting Evry Health’s digital health programs.

Qualifications

• RN diploma and active license in Texas or compact license.
• 3–5 years direct patient care experience, plus 1–2 years in health plan/MBU.
• Familiarity with CPT/ICD-10, authorizations, and pre-certification processes.
• Bilingual English/Spanish required for member interactions.

Responsabilités

• Proactive and reactive member engagement based on risk data.
• Develop and monitor individualized care plans and coordinate resources.
• Educate members and providers on benefits and self-management.
• Serve as liaison between UM team, providers, and members.
• Document activities, manage escalations, and promote digital health programs.

Connaissances

Member engagement

Care coordination

Motivational interviewing

Bilingual English/Spanish

Documentation & education

Formation

Diploma in Nursing

Description du poste

Role Summary

The RN Integrated Care Coordinator is a core clinical contributor delivering comprehensive, member-centered care coordination across the care continuum for Evry Health’s fully insured commercial health plan population. The role combines proactive and reactive member engagement, and individualized care planning in a fully remote, technology-forward environment.

Roles and Responsibilities

• Proactive & Reactive Member Engagement : Conducts outreach based on risk stratification and care gap data, and responds to member/provider contacts, using motivational interviewing to build trust and drive benefit and program engagement.
• Care Plan Development & Coordination: Conducts comprehensive clinical, psychosocial, and SDOH assessments and develops individualized care plans, monitoring progress and coordinating resources across the care continuum.
• Member & Provider Education: Educates members and providers on benefits, digital health solutions, and evidence-based self-management strategies, translating complex information into clear, actionable guidance.
• Utilization Review Support: Serving as the communication bridge between the UM team, providers, and members to ensure members get the right care at the right place of service.
• Documentation, Escalation Management & Digital Health Promotion: Accurately documents all care coordination and UM support activity, manages escalations to appropriate clinical resources, and promotes member enrollment in Evry Health’s digital health programs.

Qualifications

• Diploma from an accredited school of nursing required; ADN or higher preferred
• Current, unrestricted Texas RN license or active Compact (NLC) nursing license required
• 3–5 years of nursing experience in a direct patient care setting, plus 1–2 years in a health plan or managed care organization, preferably with a commercial population
• Working knowledge of health plan benefits, CPT/ICD-10 codes, authorizations, and pre-certification processes
• Bilingual English/Spanish fluency required

Preferred

• Bachelor of Science in Nursing (BSN) or higher
• Certified Case Manager (CCM) credential or American Case Management (ACM) certification
• Experience in telephonic care coordination, outreach nursing, or call center-based patient engagement
• Experience with HEDIS measures, care gap closure, or UM background (MCG/InterQual guidelines)

Telecommuting Requirements

• This is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas. Candidates must reside in the Eastern or Central time zones.
• Company business hours are weekdays 9-5 CST.
• Required to have a dedicated work area established that is separate from other living areas and provides information privacy.
• Ability to keep all company sensitive documents secure.
• Must live in a location that receives an existing high-speed internet connection/service.

$80,000 - $90,000 a year