Spanish Bilingual Complex Care RN

This is a fully remote position, open to applicants in California.

📋 Description

• Oversee and coordinate care for Medicare Advantage members with complex medical needs.

• Establish trustworthy relationships with members and caregivers through consistent virtual interactions.

• Manage transitions of care after hospital, skilled nursing facility (SNF), and inpatient discharges.

• Conduct medication reconciliations and track changes in clinical conditions.

• Recognize and escalate clinical issues to the relevant provider.

• Collaborate with multidisciplinary teams to guarantee seamless and coordinated care.

• Assist in managing chronic diseases such as heart failure, COPD, diabetes, and chronic kidney disease (CKD).

• Support initiatives related to HEDIS, quality improvement, and closing care gaps.

• Ensure accurate and timely documentation within the Athena EMR system.

• Work alongside Advanced Practice Clinicians, Care Coordinators, Health Coaches, Social Workers, and Primary Care Providers within the Care Anywhere model.

⛳️ Requirements

• Applicants must be residents of the South Bay San Diego region.

• Bilingual in Spanish and English (ability to read, write, and speak).

• At least 3 years of RN experience in complex care, care management, case management, transitions of care, palliative care, hospice, acute care, or a similar clinical environment.

• Experience in managing high-risk patient populations with complex medical conditions.

• Familiarity with chronic disease management, medication reconciliation, and coordination of care transitions.

• Background in Medicare Advantage, managed care, home-based care, or value-based care settings.

• Understanding of HEDIS, HCC coding, and care gap management.

• Experience in telehealth or virtual care environments.

• Strong skills in interdisciplinary care coordination and communication.

• Associate Degree in Nursing (ADN) is required.

• Must hold an active, unrestricted RN license in California.

• Current BLS certification is necessary.

• A BSN or higher degree is strongly preferred.

• Certification as a Certified Case Manager (CCM) is preferred.

• Multi-state RN licensure is preferred.

• Experience with Athena EMR and TalkDesk or similar virtual engagement platforms is preferred.

• A background in population health, care management programs, or Medicare case management is preferred.

• Capability to perform essential physical functions, including frequently lifting and/or moving up to 10 pounds.

🏝️ Benefits

• Ample opportunities for growth and innovation.

• Function at the highest level of your license while supporting high-risk populations.

• Engage in an innovative care model that is transforming senior healthcare.

• Collaborate with a committed, multidisciplinary care team.

• Directly influence the reduction of hospitalizations and enhancement of member outcomes.

• Be part of a mission-driven organization dedicated to compassionate and coordinated care.

• Reasonable accommodations may be provided to enable individuals with disabilities to perform essential job functions.