Alignment Health

Compensation

Full Description

Description: • Responsible for health care management and coordination, within the scope of RN licensure, for members with complex and chronic care needs • Delivers care to members utilizing the nursing process and interacts with members, caregivers, and interdisciplinary team participants • Assist with closing gaps in care and resolving barriers to improved health • Reaches out and connects with members via telephone • Coordinates care as a resource for members, families, and physicians • Ensures access to appropriate care for urgent or immediate needs, facilitating referrals/authorizations • Completes comprehensive assessments of member health status, resource utilization and treatment plans • Collaborates with PCPs and care team to implement care plans and interfaces with hospitalists, NPs and specialists • Provides education and self-management support tailored to member learning styles • Works closely with delegated or contracted providers to assure effective care coordination • Maintains confidentiality of PHI in compliance with law and company policy Requirements: • Minimum 2 years clinical experience • Minimum 1 year case management experience • Health Plan experience preferred • Required: Successfully passing Post High School courses to obtain an RN licensure or AS in Nursing • Preferred: BSN or Bachelor's • 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) (reimbursed by company) • 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 constructive relationships with diverse stakeholders • 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 and reasoning skills • Ability to comprehend and analyze statistical reports • Must be willing to work 8:00am - 5:00pm Pacific Time Benefits: • Fully Remote • Reimbursement for obtaining LVN and/or RN licensure in Nevada, Arizona, North Carolina, and Texas • Ample room for growth and innovation within a fast-growing company • Opportunity to do work that really matters and save lives