Remote Bilingual Spanish Complex Care RN

Alignment Health; Fresno (CA); On-site; USD 86,000 - 129,000; Full time

Job summary

Alignment Health is seeking a Complex Care RN (CCM RN) to own the member journey through virtual care, coordinating across APCs, Health Coaches, and Social Workers. The role focuses on high-acuity Medicare Advantage members, ensuring timely, proactive care in a fully remote delivery model.

The CCM RN will manage transitions of care, medication reconciliation, and escalation of clinical concerns while supporting PCP and RMO collaborations. ABSN/ADN with active RN license required.

Qualifications

• Minimum 3 years of clinical RN experience with direct patient care in complex care, care management, transitions of care, or related settings.
• Active RN license in applicable state(s); multi-state licensure preferred.
• Experience in Medicare Advantage, care coordination, and transitions of care.
• Experience delivering care via telehealth or virtual platforms.
• Proficiency with Athena EMR and virtual engagement platforms.

Responsibilities

• Own the member journey and care coordination for high-acuity Medicare Advantage members.
• Manage transitions of care and post-discharge coordination to reduce readmissions.
• Complete medication reconciliations and monitor clinical indicators.
• Escalate clinical concerns and support APC clinical decision-making.
• Coordinate cross-disciplinary care within the pod and with external care partners.
• Support HEDIS, quality improvement, and care-gap closure.
• Manage chronic condition care pathways per GDMT and guidelines.
• Document all interactions accurately in Athena within required timeframes.

Skills

Care coordination

Telehealth

Virtual care delivery

Communication

Team collaboration

Education

ADN/BSN

RN license

Multi-state licensure

Tools

Athena EMR

TalkDesk

Job description

Alignment Health is seeking a Complex Care RN (CCM RN) to own the member journey through virtual care, coordinating across APCs, Health Coaches, and Social Workers. The role focuses on high-acuity Medicare Advantage members, ensuring timely, proactive care in a fully remote delivery model.

The CCM RN will manage transitions of care, medication reconciliation, and escalation of clinical concerns while supporting PCP and RMO collaborations. ABSN/ADN with active RN license required.