Bilingual (English/Spanish) Transitions of Care RN Case Manager

TL;DR

Bilingual (English/Spanish) Transitions of Care RN Case Manager: Provide telephonic short-term interdisciplinary care management in the 30 days post-discharge for high-risk patients with an accent on assessments, care plans, and resource coordination. Focus on patient advocacy, chronic condition education, identifying red flags, and closing care gaps.

Location: Fully remote in Arizona, Colorado, Washington, or Oregon. Candidates must be located in CT/MT/PT time zones. Working hours: Monday-Friday 10am-6:30pm ET or 10:30am-7:00pm ET. Unrestricted Compact RN license in the United States required, with ability to secure other state licenses.

Salary: $85,000 - $100,000 / year

Company

hirify.global is an all-in-one healthcare company combining health insurance, clinical care, service, and technology to deliver integrated solutions for older Americans.

What you will do

• Engage telephonically with newly discharged patients to assess needs, comorbid conditions, hospitalization history, medications, psychosocial factors, and preferences.
• Develop and evaluate personalized care plans in partnership with patients and caregivers.
• Educate patients on chronic conditions, red flags, exacerbation plans, and barriers to care like medication adherence.
• Partner with TOC Nurse Practitioners, Physicians, Community Guides, PCP partners, and community organizations for coordinated post-discharge care.
• Coordinate post-treatment care, DME needs, referrals to Devoted Medical, and smooth handoffs.
• Explain medical terms in plain language and provide active management to address care gaps.

Requirements

• Unrestricted Compact RN license in the United States with ability to secure licenses in other states.
• 3-4 years of RN care management or telephonic case management experience.
• Fully bilingual in English/Spanish.
• Location in CT/MT/PT time zones for specified working hours.

Nice to have

• Health insurance experience, particularly Medicare Advantage.
• Prior Special Needs Plan, Population Health, or Transitions of Care experience.
• Telephonic care/case management experience.
• Clinical analytical thinking for individualized patient needs.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and parental leave program.
• 401K program, stock options, and bonus eligibility.
• $100 monthly mobile or internet stipend.
• Startup environment focused on innovation, integrity, excellence, and patient empowerment.