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Alignment Health
Alignment Health
501 – 1,000 Employees
HealthcareHealthcare InsuranceInsurance
Alignment Health is a healthcare insurance company focused on improving care for Medicare members, particularly seniors, people living with chronic conditions, and those who are frail. Founded in 2013, the company combines a personalized care model with technology and a 24/7 concierge care team to coordinate support with trusted local providers. Its work spans healthcare delivery and insurance, with a focus on making care more accessible, responsive, and cost-conscious for its members. Alignment Health hires across a growing healthcare organization serving the needs of Medicare communities.
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Remote Bilingual Spanish RN Case Manager, Transition of Care

Coordinate complex and chronic care for Alignment Health members through remote case management. Develop care plans, arrange authorizations and referrals, and collaborate with providers by phone.

USUnited States
$79,697 – $119,545 / year
RemoteFull-timeMiddleSeniorEnglish RequiredSpanish RequiredBilingual

Description

  • Connect members with services that address their health needs.
  • Assess members and manage their cases according to established criteria.
  • Carry out care plans by arranging authorizations and referrals within members’ benefits or through special arrangements.
  • Use independent judgment to assess authorization requests and coordinate internal and external resources.
  • Track care plan effectiveness and adjust plans when needed.
  • Coordinate treatment plans with primary care physicians, hospitalists, nurse practitioners, and specialists.
  • Negotiate reimbursement rates when applicable.
  • Help resolve provider, claims, and service issues.
  • Evaluate intervention results to measure case management outcomes.
  • Contribute feedback on utilization and care management policies and procedures.
  • Discuss available care options with patients and families to help them choose suitable and preferred next steps.
  • Perform most duties by phone.

Requirements

  • At least five years of clinical case management experience, or an equivalent combination of education and experience.
  • Associate or bachelor’s degree in nursing.
  • Current, unrestricted RN license in the state where you are applying.
  • Ability to communicate positively, professionally, and effectively; provide leadership; teach; and collaborate.
  • Strong written and verbal communication skills, with the ability to build constructive relationships with diverse members, managers, employees, and vendors.
  • Problem-solving, organization, and time management skills, and the ability to work in a fast-paced setting.
  • Ability to meet essential physical requirements, including standing, walking, sitting, using hands and fingers, reaching, talking, hearing, lifting and moving up to 10 pounds, and performing close-vision tasks and adjusting focus.

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