Manager, Case Management, RN
Alignment Health
full-time
Posted on:
Location Type: Remote
Location: California • United States
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Salary
💰 $113,332 - $169,999 per year
About the role
- Responsible for the health care management and coordination of care for members with complex and chronic care needs
- Assures compliance with SNP program requirements as outlined in the Model of Care
- Monitors activities to support the timeliness of Health Risk Assessment completion
- Monitors and reports program performance, including vendor performance monitoring
- Oversee audits, regulatory compliance, and quality assurance activities
- Provide coaching, performance reviews, and staff development to support team success
Requirements
- Minimum 5 years of clinical case management experience
- Minimum 1 year of experience working with SNP programs in a health plan
- California RN license required
- Willing to obtain an RN license in all of our states markets
- At least 2 years of supervisory or team lead experience in a managed care or health plan setting
- Strong knowledge of CMS SNP Model of Care and Medicare Managed Care Plans
- Experience with utilization review criteria (e.g., MCG guidelines)
- Comfortable navigating EHR systems and healthcare technology platforms
Benefits
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Remote work options
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical case managementSNP program compliancehealth risk assessmentvendor performance monitoringauditsregulatory compliancequality assuranceutilization review criteriaEHR systemshealthcare technology
Soft Skills
coachingperformance reviewsstaff developmentteam success
Certifications
California RN license