Remote Complex Care RN — Bilingual (Spanish/English)

Alignment Health; San Diego, Northern (CA, KY); Hybrid; USD 86,000 - 129,000; Full time

Job summary

Alignment Health in San Diego, CA is seeking a Remote Complex Care RN (bilingual Spanish/English) to serve as the clinical quarterback for high-risk Medicare Advantage members in a virtual care model.

You will build relationships, lead transitions of care, perform medication reconciliations, and coordinate with physicians and a multidisciplinary team to improve outcomes while supporting chronic disease management.

Qualifications

• Minimum 3 years of RN experience in complex care, care management, transitions of care, or related clinical settings.
• Experience with Medicare Advantage, managed care or value-based care environments.
• Experience working in telehealth or virtual care settings.
• Knowledge of HEDIS, HCC coding, and care gap management.

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 escalate 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

Bilingual: Spanish & English

RN

Care coordination

Telehealth experience

HEDIS knowledge

Education

Associate Degree in Nursing (ADN)

BSN preferred

Tools

Athena EMR

TalkDesk

Job description

Alignment Health in San Diego, CA is seeking a Remote Complex Care RN (bilingual Spanish/English) to serve as the clinical quarterback for high-risk Medicare Advantage members in a virtual care model.

You will build relationships, lead transitions of care, perform medication reconciliations, and coordinate with physicians and a multidisciplinary team to improve outcomes while supporting chronic disease management.