Remote Complex Care RN - Virtual Care Navigator

E2E Alignment Healthcare USA, LLC; California; Híbrido; USD 86.000 - 129.000; Jornada completa

Descripción de la vacante

Alignment Health is seeking a Complex Care Registered Nurse to act as the clinical quarterback for high-risk Medicare Advantage members in a virtual care model. You will coordinate proactive care, engage members and caregivers, and collaborate with clinicians to improve outcomes.

Licensed in California with BLS and bilingual English/Spanish preferred, you will support transitions of care, medication reconciliation, and chronic disease management within a multidisciplinary team.

Formación

• Minimum 3 years RN experience in complex care, care management, transitions of care, palliative care, hospice, acute care, or related clinical setting.
• Experience with Medicare Advantage and value-based care environments.
• Active CA RN license and current BLS certification.
• Experience with telehealth or virtual care.
• Knowledge of HEDIS, HCC coding, and care gap management.
• Multi-state RN licensure preferred.

Responsabilidades

• 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 elevate 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.

Conocimientos

RN experience

Care coordination

Telehealth

Bilingual English/Spanish

CA RN license

HEDIS knowledge

Educación

Associate Degree in Nursing (ADN)

BSN preferred

Herramientas

Athena EMR

TalkDesk

Descripción del empleo

Alignment Health is seeking a Complex Care Registered Nurse to act as the clinical quarterback for high-risk Medicare Advantage members in a virtual care model. You will coordinate proactive care, engage members and caregivers, and collaborate with clinicians to improve outcomes.

Licensed in California with BLS and bilingual English/Spanish preferred, you will support transitions of care, medication reconciliation, and chronic disease management within a multidisciplinary team.