Remote Complex Care RN; live in San Diego

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. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.

In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Are you passionate about helping medically complex patients navigate their healthcare journey? At Alignment Health, we're transforming healthcare for seniors through coordinated, value-based care.

As a Complex Care RN, you'll serve as the clinical quarterback for a panel of high-risk Medicare Advantage members, helping ensure they receive the right care at the right time while improving outcomes and quality of life.
*** Location Requirement:
Candidates must reside in San Diego County to be considered.
*** Language Requirement:
Bilingual in Spanish & English (Read, Write, Speak) is required.

• Manage and coordinate care for medically complex Medicare Advantage members.
• Build trusted relationships with members and caregivers through ongoing virtual engagement.
• Lead transitions of care following hospital, SNF, and inpatient discharges.
• Complete medication reconciliations and monitor changes in clinical status.
• Identify and elevate clinical concerns to the appropriate provider.
• Partner with multidisciplinary teams to ensure seamless, coordinated care.
• Support chronic disease management for conditions including heart failure, COPD, diabetes, and CKD.
• Assist with HEDIS, quality initiatives, and care gap closure activities.
• Maintain accurate, timely documentation in Athena EMR.

• Required Located in the South Bay - San Diego, CA area Minimum 3 years of RN experience in complex care, care management, case management, transitions of care, palliative care, hospice, acute care, or a related clinical setting.
• Experience managing medically complex, high-risk patient populations.
• Experience with chronic disease management, medication reconciliation, and care transition coordination.
• Experience in Medicare Advantage, managed care, home-based care, or value-based care environments.
• Knowledge of HEDIS, HCC coding, and care gap management.
• Experience working in telehealth or virtual care settings.
• Strong interdisciplinary care coordination and communication skills.
• Bilingual English/Spanish
• Education & Licensure Associate Degree in Nursing (ADN) required; BSN strongly preferred.
• Active, unrestricted RN license in CA
• Current BLS certification.
• Preferred Qualifications BSN or higher.
• Certified Case Manager (CCM) certification.
• Multi-state RN licensure.
• Experience with Athena EMR and Talk Desk or similar virtual engagement platforms.
• Background in population health, care management programs, or Medicare case management.

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