Bilingual Case Management Nurse
Vālenz 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!
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Work Environment : You’ll need a quiet workspace that is free from distractions.
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Technology : Reliable internet