Telephonic RN Case Manager, SNP (Bilingual Preferred)

Alignment Health•Remote CA Outside Bay Area, CA

78d•$77,905 - $116,858•Remote

About The Position

Alignment Health is committed to serving seniors and the chronically ill and frail. This fast-growing company offers opportunities for growth and innovation. The fully remote RN Case Manager SNP is responsible for healthcare management and coordination for members with complex and chronic care needs. This role involves utilizing the nursing process, interacting with members and care teams, assisting with closing gaps in care, and resolving barriers to improved health, primarily through telephone outreach.

Requirements

Minimum 2 years' clinical experience
Minimum 1 year case management experience.
Successfully passing Post High School courses to obtain an RN licensure or AS in Nursing.
Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs
Extensive knowledge of the management of chronic conditions
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
Ability to operate PC-based software programs including proficiency in Word, Excel and PowerPoint
Ability to perform mathematical calculations and calculate simple statistics correctly
Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Comprehend and analyze statistical reports.
Must have and maintain an active, valid, and unrestricted RN license in California (Non-Compact)
Immediately upon hire, must be willing to obtain LVN and / or RN licensure in Nevada, (Non-compact), Arizona (Compact), North Carolina (Compact), and Texas (Compact) which will be reimbursed by company.

Nice To Haves

Bilingual Preferred
Health Plan experience preferred
BSN or Bachelor's

Responsibilities

Coordinates care by serving as a resource for the member, their family, and their physician.
Ensures access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate.
Completes comprehensive assessments within their scope of practice that includes assessing the member's current health status, resource utilization, past and present treatment plan, and services.
Collaborates with the member, the PCP, and other members of the care team to implement a plan of care.
Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners, and specialists on the development of care management treatment plans.
Provides education and self-management support based on the member’s unique learning style.
Assists in problem solving with providers, claims or service issues.
Works closely with delegated or contracted providers, groups, or entities to assure effective and efficient care coordination.
Maintains confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy.