Bilingual Spanish, RN Care Manager

Role Overview

• Engage and provide telephonic care coordination and management to identified patient populations
• Collaborate with members of Clover clinical teams
• Initiate referrals to specialty services and foster continuity of care
• Create personalized care plans for each member
• Document all member care activities and escalate findings
• Coordinate with the interdisciplinary team and outpatient providers
• Provide telephonic teaching and counseling in health promotion and disease management
• Attend regular ongoing meetings
• Demonstrate flexibility in assignments within Clover’s Clinical Programs
• Advocate for members to ensure needs and choices are represented
• Participate in ongoing professional development

Requirements

• At least 3 years of post-licensure care management experience
• Bachelor’s degree (BSN) or higher from an accredited school of nursing
• Current valid RN multi-state license
• Fluency in English and Spanish, both orally and in writing
• Case Management certification or completion of CCM certification within 1 year of employment (preferred)
• Experience in completion of assessment, care plans, care coordination, and issue resolution
• Knowledgeable about healthcare reimbursement, utilization management, discharge planning, and disease management
• Experience in geriatrics and chronic illness management
• Basic knowledge of Medicare and Medicare Advantage Plans
• Comfortable with documenting electronic medical records and utilizing electronic data and reports
• Intermediate level computer skills on Mac and PC platforms

Benefits

• Health insurance
• 401k matching
• Performance-based bonuses
• Comprehensive medical, dental, and vision coverage
• 18 days of vacation per year
• 10 federal holidays plus 5 additional paid holidays
• Paid parental leave
• Reimbursement for office setup expenses
• Employee Stock Purchase Plan (ESPP)