Bilingual RN Case Manager, SNP - Must have California RN License (Non-Compact)

Alignment Healthcare LLC; Hyde Park Township (IL); Remote; USD 77,000 - 117,000; Full time

Job summary

Join a forward-thinking healthcare company as a Bilingual RN Case Manager, where you'll play a crucial role in transforming the lives of seniors and those with chronic conditions. This fully remote position offers the chance to work with a dedicated team, providing essential care management and coordination for members. You'll leverage your clinical expertise to assess health needs, facilitate care access, and collaborate with healthcare providers. If you're passionate about making a meaningful impact in the healthcare sector and thrive in a supportive environment, this opportunity is perfect for you. Embrace the chance to grow professionally while contributing to a mission-driven organization that prioritizes the well-being of its members.

Qualifications

• Minimum 2 years' clinical experience and 1 year in case management.
• Must have active RN license in California and be willing to obtain others.

Responsibilities

• Coordinate care and ensure access for members with urgent needs.
• Conduct assessments and collaborate on care plans with the team.

Skills

Effective communication skills

Problem-solving skills

Organizational skills

Mathematical skills

Reasoning skills

Education

RN licensure or AS in Nursing

BSN or Bachelor's degree

Tools

PC-based software (Word, Excel, PowerPoint)

Job description

Bilingual RN Case Manager, SNP - Must have California RN License (Non-Compact)

Apply remote type Fully Remote locations Anywhere in the U.S.

time type Full time posted on Posted 2 Days Ago job requisition id R141

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The RN Case Manager SNP (must have RN License in California [Non-Compact]) is responsible for health care management and coordination, within the scope of licensure, for members with complex and chronic care needs. Delivers care to members utilizing the nursing process and effectively interacts with members, caregivers, and other interdisciplinary team participants. Assist with closing gaps in care and resolving barriers that prevent members from attaining improved health. Reaches out and connects with members via the telephone.

Schedule: Must be willing to work 8:00am - 5:00pm Pacific Time

GENERAL DUTIES / RESPONSIBILITIES

1. Coordinates care by serving as a resource for the member, their family, and their physician.
2. Ensures access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate.
3. Completes comprehensive assessments within their scope of practice that includes assessing the member's current health status, resource utilization, past and present treatment plan, and services.
4. Collaborates with the member, the PCP, and other members of the care team to implement a plan of care.
5. Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners, and specialists on the development of care management treatment plans.
6. Provides education and self-management support based on the member’s unique learning style.
7. Assists in problem solving with providers, claims or service issues.
8. Works closely with delegated or contracted providers, groups, or entities to assure effective and efficient care coordination.
9. Maintains confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy.

Supervisory responsibilities: N/A

Job Requirements:

Experience:

• Minimum 2 years' clinical experience
• Minimum 1 year case management experience.

Education:

• Required: Successfully passing Post High School courses to obtain an RN licensure or AS in Nursing.
• Preferred: BSN or Bachelor's

Specialized Skills:

• Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs
• Extensive knowledge of the management of chronic conditions.
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors.
• Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Ability to operate PC-based software programs including proficiency in Word, Excel and PowerPoint.
• Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly.
• Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
• Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
• Report Analysis Skills: Comprehend and analyze statistical reports.

Licensure:

• 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) which will be reimbursed by company.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $77,905.00 - $116,858.00

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.