Alignment Healthcare USA, LLC
Remote Complex Care Registered Nurse - California Residents Only (Active California RN License
Fresno, CA
Sponsorship not specified$86k-$129kDetected 7 days ago
CadenceEHR/EMRPatient CareLeadershipCommunicationCollaborationMentoring
About the role
- Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail.
- We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.
- Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them.
Responsibilities
- Own the Member Journey and Care Coordination for High-Acuity Members.
- Build trusted relationships with members and their caregivers through regular telehealth outreach - identifying changes in condition, barriers to care, and social needs that require intervention.
- Manage Transitions of Care and Hospital Discharge Coordination.
- Ensure all members' care plans are updated following transitions and that all pod team members have the clinical context needed to support the member.
- Escalate Clinical Concerns and Support APC Clinical Decision-Making.
- The CCM RN leads through clinical expertise and care coordination within the pod - all formal people management matters are owned by the Manager, Clinical Operations.
- Own transitions of care for members discharging from hospitals, SNFs, and other inpatient settings - completing timely post-discharge outreach, medication reconciliation, and follow-up coordination to reduce avoidable readmissions and support safe, effective transitions back to the community.
- Serve as the central communication point for caregivers - ensuring updates, care plan changes, and clinical concerns are shared promptly and accurately with all pod members and external care partners.
- Support HEDIS, Quality, and Care Gap Closure.
- Manage Chronic Condition Care Pathways and Guideline-Directed Care Delivery.
Requirements
- Minimum 3 years of clinical RN experience - with direct patient care in complex care, care management, transitions of care, case management, palliative care/hospice, acute care, or a related clinical setting
- Prior experience in a Medicare Advantage, managed care, home-based care, or value-based care environment with working knowledge of HEDIS, HCC coding, and care gap management
- Demonstrated ability to coordinate care across multiple disciplines and communicate effectively with clinical and non-clinical team members
- Experience with Athena EMR and TalkDesk or equivalent virtual engagement platform
- Demonstrated proficiency with telehealth delivery platforms
Nice to have
- Associate Degree in Nursing (ADN).
- Bachelor of Science in Nursing (BSN) strongly preferred
- Active, unrestricted Registered Nurse (RN) license in applicable state(s)
- Multi-state licensure preferred given fully virtual, multi-market model
- Current BLS certification
- BSN or higher from an accredited nursing program
- Case Management Certification (CCM) or equivalent care management credential
Skills
- Active, unrestricted RN license in applicable state(s)
- BLS certification
- Multi-state licensure preferred
- Certified Case Manager (CCM)
- ACLS certification
- Essential Physical Functions:
Compensation
- $85,696.00 - $128,543.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Benefits
- In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community.
- Background in population health, care management programs, or complex case management for Medicare populations
- Formal training in motivational interviewing, health coaching, or complex care management
Company info
- It takes an entire team of passionate and caring people, united in our mission to put the senior first.
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