Bilingual Spanish RN, Care Management (Riverside)

SHPCA SCAN Health Plan; California; Hybrid; USD 61,192 - 84,309; Full time

Benefits offered by this job

Annual employee bonus program

Robust wellness program

Generous paid-time-off (PTO)

Job summary

SHPCA SCAN Health Plan seeks a Registered Nurse (RN) for Care Management in California. This hybrid remote position involves providing person-centered care management to members with complex needs.

The role requires strong clinical expertise and the ability to conduct assessments and develop care plans. Benefits include competitive pay, annual bonuses, generous PTO, and a robust retirement plan.

Qualifications

• 3+ years of clinical experience in care management or related setting preferred.
• Experience working with high-risk, complex, or chronically ill populations preferred.
• Valid driver's license and reliable transportation required.

Responsibilities

• Conduct comprehensive assessments in members' homes and via telephonic encounters.
• Develop individualized care plans with measurable goals.
• Coordinate care with primary care providers and community resources.

Skills

Clinical experience in care management

Bilingual in English/Spanish

Leadership and problem solving

Interpersonal communication

Education

Bachelor's degree in nursing (BSN)

CA Registered Nurse (RN) license

Certified Case Manager (CCM) certification

Tools

Documentation systems

Job description

Position Summary

Registered Nurse (RN) – Care Management – hybrid remote and in-field in Riverside, CA and surrounding areas. Responsible for delivering high‑touch, person‑centered care management to members with complex medical needs who cannot be effectively supported through telephonic care management alone.

Responsibilities

• Conduct comprehensive clinical, functional, and environmental assessments in members’ homes and via telephonic encounters.
• Identify clinical, functional, medication, caregiver, and environmental risks; develop individualized care plans with measurable goals; integrate evidence‑based guidelines.
• Provide disease‑specific education, coaching, and self‑management support; use teach‑back for understanding.
• Support medication safety, reconciliation, adherence; coordinate with providers and pharmacies.
• Coordinate care with primary care providers, specialists, hospitals, skilled nursing facilities, home health, and community resources to ensure continuity.
• Collaborate with Social Workers, Community Health Workers, Care Coordinators, and other interdisciplinary team members; participate in case reviews, huddles, and interdisciplinary discussions.
• Adhere to SNP Model of Care requirements, CMS, DHC, DHCS regulations, and California Integrated Care Management (CICM) activities for specified Populations of Focus.
• Complete timely documentation across multiple systems – care plans, service plans, progress notes.
• Manage transitions of care after emergency department visits, hospitalizations, or facility discharges; provide follow‑up, risk mitigation, and education on red‑flag symptoms.
• Perform nursing related CICM activities for individuals experiencing homelessness, at risk for avoidable hospital or ED utilization, adults at risk of LTC institutionalization, nursing facility residents transitioning back to community, documented dementia, serious mental illness (SMI) and substance use disorder (SUD).
• Other duties as assigned and support SCAN’s vision and goals.

Qualifications

• Bachelor’s degree in nursing (BSN) required.
• CA Registered Nurse (RN) license required.
• Graduate or advanced degree or equivalent experience preferred.
• Certified Case Manager (CCM) certification strongly preferred.
• Bilingual in English/Spanish required (proficiency test will be administered if applicable).
• 3+ years clinical experience in care management, case management, home health, community‑based care, or related setting preferred.
• 2+ years working with seniors and hybrid remote strongly preferred.
• Experience working with high‑risk, complex, or chronically ill populations preferred.
• Leadership, problem‑solving, strategic mindset, strong interpersonal, written and verbal communication, organizational, critical thinking, multitasking, confidentiality.
• General understanding of NCQA, CMS, DHCS regulations and medical terminology.
• Deep knowledge of local community resources for seniors.
• Valid driver’s license, automobile insurance, reliable transportation; 50%+ travel required.

Additional Requirements

Compliance with Tuberculosis Screening Policy: proof of screening or negative result within last year required.

Compensation & Benefits

• Base salary range: $44.42 to $61.20 per hour.
• Hybrid work mode.
• Annual employee bonus program.
• Robust wellness program.
• Generous paid‑time‑off (PTO).
• Eleven paid holidays per year plus one floating holiday and one birthday holiday.
• Excellent 401(k) retirement savings plan with employer match and contribution.
• Robust employee recognition program.
• Tuition reimbursement.

Equal Employment Opportunity

We are an Equal Employment Opportunity and affirmative action workforce. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity, marital status, disability, protected veteran status or any other status protected by law.