Bilingual Case Management Nurse

Bilingual Case Management Nurse

V?lenz Health is the destination for employers, brokers, payers, and providers to reduce costs, improve quality, and elevate the healthcare experience. Through advanced technology and clinical expertise, Valenz creates a distinctly different approach to a complex healthcare system. With our solutions, we execute across the entire healthcare journey from member experience to payment integrity, provider quality, and plan performance. With one of America's largest cost, quality and utilization datasets, we create greater transparency, flexibility, and cost containment empowering members and employers with the information they need to make smarter, more cost-effective decisions.

About Our Opportunity As a Bilingual Case Management Nurse, you'll play a key role in managing comprehensive, patient-centered care across diverse health needs. Drawing on your clinical expertise, you'll assess patient needs, develop individualized care plans, and collaborate with multidisciplinary teams to ensure seamless communication and continuity of care. You'll support patients in navigating the healthcare system, promote adherence to treatment plans, and serve as a trusted advocate by providing education, emotional support, and guidance throughout their journey. In this role, you'll also contribute to wellness initiatives, optimize resource utilization, and help ensure compliance with organizational and regulatory standards to drive quality outcomes.

Things You'll Do Here:

• Coordinate and manage healthcare services to ensure comprehensive, patient-centered care and effective communication among providers.
• Assess patients' medical needs and develop individualized care plans aligned with their conditions and health goals.
• Advocate for patients by supporting their rights, preferences, and access to appropriate services throughout the healthcare system.
• Monitor patient progress, adherence to care plans, and the effectiveness of interventions, adjusting as necessary.
• Document assessments, care plans, and outcomes accurately and in a timely manner.
• Generate reports on patient status, care outcomes, and resource utilization.
• Educate patients on medications, treatment plans, and self-care practices.
• Provide emotional support and counseling to patients and their families, addressing concerns and fostering trust.
• Promote preventive care and wellness through health education and lifestyle guidance.
• Ensure compliance with URAC standards, CMSA Standards of Practice, and all applicable federal, state, and local regulations, as well as Valenz policies.
• Collaborate with internal teams to identify opportunities for health plan coverage savings when appropriate.
• Perform other duties as assigned.

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. What You'll Bring to the Team:

• Active, unrestricted Registered Nurse (RN) license in state of residence; Compact License (NLC) accepted if residing in a compact state.
• 3+ years of nursing experience in an acute care setting
• Ability to communicate fluently in both English and Spanish, verbally and in writing.
• Proven ability to work in a deadline-driven environment with strong attention to detail and organizational skills.
• Demonstrated critical thinking and sound judgment in complex situations, with appropriate escalation as needed.
• Excellent communication and interpersonal skills, with a collaborative approach to care coordination.

A plus if you have:

• Compact State Nursing License (if not already held).
• Case management experience
• Relevant certification (e.g., Certified Case Manager (CCM), Chronic Care Professional (CCP), or willingness to obtain CCM within 18 months of hire.

Where You'll Work: This is a fully remote position, and we'll provide all the necessary equipment!

• Work Environment : You'll need a quiet workspace that is free from distractions.
• Technology : Reliable internet connectionif you can use streaming services, you're good to go!
• Security : Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
• Location : You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.

Why You'll Love Working Here Our mission is to advance healthcare through technology and expertise to optimize cost, quality, access, and utilization for all. We bring that mission to life through our commitment to Collaboration, Performance, Transparency, and Trustthe core values that guide how we work with our members, our customers, and each other. Benefits

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card
• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.