Responsible for health care management and coordination within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Coordinates and monitors Alignment Healthcare member's progress and services to ensure consistent cost-effective care that complies with Alignment policy and all state and federal regulations and guidelines. Performs duties mostly telephonically.
Remote Case Manager - Transitions of Care Nurse (CA RN License)Are you a California-licensed RN passionate about guiding patients through safe, seamless care transitions? Join our team as a
Remote Case Manager, where you'll make a direct impact on patient outcomes by coordinating discharge planning, referrals, and community resources.
What You'll Do:- Create individualized discharge plans with patients, families, and the care team.
- Coordinate care with providers, rehab facilities, and home health agencies.
- Monitor patient progress and adjust plans as needed.
- Educate and empower patients and families for self-care and follow-up.
- Advocate for patient needs and connect them to community support services.
- Participate in care conferences, quality improvement initiatives, and interdisciplinary collaboration.
What We're Looking For:- 5 years of clinical case management experience; or any combination of education and experience, which would provide an equivalent background.
- Active, unrestricted RN license in California (willing to obtain other state licenses).
- Knowledge of Medicare Managed Care Plans, insurance regulations, and community resources.
- Strong communication, problem-solving, and organizational skills.
Why Join Us:- Fully remote role with flexible scheduling.
- Opportunity to lead impactful patient care initiatives.
- Collaborate with a supportive, interdisciplinary team.
- Professional growth and continuous learning opportunities.
Take the next step in your career and help patients transition safely from hospital to home.
Apply today! Essential Physical Functions:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $85,696.00 - $128,543.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
