Bilingual Senior Health & Wellness Nurse

Description

At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full-suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management. As part of the Western Growers Family of Companies, we are committed to providing our employees with everything they need to succeed and grow. We know that taking care of our clients starts with taking care of our employees. As a keystone of our philosophy, we recognize that every person on our team comes to us with a unique background, history and story that adds strength to our organization. Additionally, employees are encouraged to recognize that there isn’t a work life and a home life, there is one life. This recognition throughout the organization emphasizes the value of finding a healthy and happy balance in every employee’s life. One way this is realized for employees of Pinnacle Claims Management is flexible work arrangements with work-from-home, in-office or hybrid options. With competitive compensation packages, premier investment support, enriching personal development and more, we strive for our employees’ job satisfaction and success.

Compensation : $70,978.23- $120,000 with a rich benefits package that includes profit-sharing.

Job Description Summary

Reporting to the Manager of Health and Wellness, the Bilingual Senior Health & Wellness Nurse is a senior-level clinical leader responsible for overseeing, training, mentoring, and executing the wellness and disease management, programs for Pinnacle Claims Management Inc. (PCMI). This role requires advanced expertise and plays a key role in promoting clinical excellence. In addition to administrative and clinical oversight, this position provides direct health coaching to members, leveraging evidence-based strategies to empower behavior change and improve self-management of chronic and preventive conditions. The nurse will coach and guide members in managing hypertension, diabetes, hyperlipidemia, asthma, pregnancy, weight loss, anxiety and depression, and nicotine cessation. Coaching will incorporate motivational interviewing, goal setting, and personalized care planning to support sustained lifestyle improvements and improved quality of life.

Qualifications

• Bachelor’s degree (or equivalent) and three (3) to five (5) years of experience in health management programs, preferably within a Third-Party Administrator (TPA) health plan or corporate environment, preferred.
• Current RN licensure, required.
• Certified Health Coach credential, preferred.
• Excellent oral and written communication skills in English and Spanish, required.
• Skilled in motivational interviewing, behavior change models, and goal-setting techniques to support member engagement and sustained lifestyle improvements.
• Strong knowledge of HIPAA, and other relevant regulatory and accreditation standards related to care management and patient privacy.
• Proven ability to lead and mentor clinical and non-clinical staff and quality improvement initiatives.
• Experience delivering care management and coaching via virtual platforms, with a high level of comfort in remote work and in person environments.
• Ability to assess member needs using evidence-based guidelines and develop individualized care plans that address both clinical and psychosocial factors.
• Familiarity with population health management principles and strategies to identify high-risk members and reduce preventable healthcare utilization.
• Capacity to manage multiple priorities, meet deadlines, and work both independently and collaboratively in a fast-paced environment.
• Strong critical thinking, clinical documentation, and decision-making skills.
• Internet access provided by a cable or fiber provider with 40 MB download and 10 MB upload speeds.
• Home router with wired Ethernet (wireless connections and hotspots are not permitted).
• A designated room for your office or steps taken to protect company information (., facing computer towards wall,
• A functioning smoke detector, fire extinguisher, and first aid kit on site.
• Verifiable, clean DMV record and the ability to travel to various locations throughout the . (mainly California and Arizona) up to 25% of time.

Duties And Responsibilities

Health Management

Clinical Outcomes and Documentation

Other

Physical Demands / Work Environment

The physical demands and work environment described here represent those that an employee must meet to successfully perform this job’s essential functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate with others. The employee frequently is required to travel to both indoor and outdoor areas that can vary in exposure and temperature. The employee is frequently required to operate a motor vehicle, use objects, tools, or controls, and / or required to lift up to 50lbs. The noise level in the work environment is usually moderate.#LI-Remote