Telephonic RN Case Manager – Special Needs Plan, Bilingual Preferred

Alignment Health

. Provide telephonic case management to medically complex and chronically ill Special Needs Plan members .

Posted 10/2/2026full-timeRemote • California • United StatesJuniorMid-Level💰 $77,905 - $116,858 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in telephonic case management for medically complex patients, conducting health assessments, and creating individualized care plans. Proficient in coordinating care with healthcare professionals and educating members on disease management while ensuring compliance with HIPAA regulations.

Highest-signal resume keywords

Active RN License In CaliforniaClinical Nursing ExperienceCase Management ExperienceProficiency With Microsoft OfficeBilingual Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Telephonic Case ManagementHealth AssessmentsIndividualized Care PlansDisease Management EducationCare Coordination

Soft Skills

AdvocacyCommunicationProblem-Solving

Tools & Technologies

Microsoft OfficeTeams

Certifications & Qualifications

RN License In CaliforniaWillingness To Obtain RN Licensure In Other States

Industry Keywords

Special Needs PlanHealth Plan ExperienceHIPAA ComplianceChronic Illness Management

About the role

Key responsibilities & impact

Provide telephonic case management to medically complex and chronically ill 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
Conduct all communication 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)
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 after hire
Bilingual candidates preferred, including Spanish, Korean, Mandarin, or other languages
Previous health plan or IPA experience preferred
Bachelor's Degree in Nursing (BSN) preferred
HIPAA-compliant workspace
Must work Pacific Time hours
Position is not open to LVNs

Benefits

Comp & perks

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
Competitive compensation