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Bilingual Spanish RN Case Manager – Medicare Special Needs Program
Alignment Health. Provide telephonic case management to medically complex and chronically ill Medicare Special Needs Plan members .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in telephonic case management for medically complex Medicare Special Needs Plan members, with a focus on conducting health assessments, creating care plans, and coordinating with healthcare partners. Proficient in Microsoft Office and committed to maintaining HIPAA compliance while providing education and advocacy for members.
Highest-signal resume keywords
Active RN License in CaliforniaClinical Nursing ExperienceCase Management ExperienceBilingual in Spanish or VietnameseProficiency with Microsoft Office
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Telephonic Case ManagementHealth AssessmentsIndividualized Care PlansDisease Management EducationCare Coordination
Soft Skills
AdvocacyCommunication
Tools & Technologies
Microsoft OfficeTeams
Certifications & Qualifications
Active RN License in California
Industry Keywords
Medicare Special Needs PlanHIPAA ComplianceHealth Plan ExperienceIPA ExperienceChronic Illness Management
About the role
Key responsibilities & impact- Provide telephonic case management to medically complex and chronically ill Medicare Special Needs Plan members
- Conduct comprehensive health assessments and create individualized care plans
- Coordinate care with internal and external partners, including physicians and specialists
- Educate members and caregivers on disease management and preventive care
- Monitor member progress and advocate for timely, appropriate interventions
- Identify and help resolve service or access issues impacting care quality
- Communicate via phone, email, and Teams
- Perform essential physical functions including talking, hearing, standing, walking, sitting, handling objects or controls, reaching, and occasionally lifting or moving up to 10 pounds
Requirements
What you’ll need- Active, unrestricted RN license in California (Non-Compact), required upon hire
- Minimum 2 years of clinical nursing experience
- At least 1 year of case management experience
- Proficiency with Microsoft Office (Word, Excel, Outlook)
- Must be willing to obtain RN licensure in Nevada, Arizona, North Carolina, and Texas; company reimburses costs
- Must work Pacific Time hours
- HIPAA-compliant workspace
- Bilingual candidates strongly preferred, including Spanish and Vietnamese
- Previous health plan or IPA experience preferred
- Bachelor's Degree in Nursing (BSN) preferred
- Position is not open to LVNs
Benefits
Comp & perks- Competitive compensation
- Full suite of health benefits (medical, dental, vision)
- 401(k) with employer match
- Generous PTO and paid holidays
- Career growth and continuing education support
- Rewarding referral bonuses for successful hires
- Company-provided equipment and IT support included
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions