Complex Care Registered Nurse

Complex Care Registered Nurse (CCM RN)

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.

The Complex Care RN (CCM RN) serves as the clinical center of the Care Anywhere pod — owning the member journey, coordinating care across disciplines, and ensuring the highest-acuity Medicare Advantage members receive timely, proactive, and coordinated care in a fully virtual delivery model. Embedded within a team-based pod alongside APCs, Health Coaches, Care Coordinators, Medical Assistants, and Social Workers, the CCM RN manages transitions of care, drives member engagement cadence, escalates clinical concerns, and serves as the central coordination point for all caregivers involved in a member's care.

This role is critical to the approved virtual health model because the CCM RN directly enables APCs to work at the top of their license — handling the coordination, monitoring, and transition work that would otherwise consume APC time — and ensures the organization's most vulnerable members never fall through the cracks.

Own the Member Journey and Care Coordination for High-Acuity Members. Serve as the primary care coordinator for an assigned panel of medically complex, high-risk Medicare Advantage members — maintaining consistent engagement cadence, proactively monitoring clinical status, and ensuring all care activities across the pod are connected and moving forward. 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. 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. Ensure all members' care plans are updated following transitions and that all pod team members have the clinical context needed to support the member.

Complete Medication Reconciliations and Clinical Monitoring. Conduct medication reconciliations for assigned members — reviewing medication lists for accuracy, appropriateness, and adherence, identifying potential interactions or concerns, and escalating clinical findings to the APC as appropriate. Monitor for symptom changes, lab values, and care gap alerts — facilitating outreach and coordinating responses across the pod when abnormal findings require action.

Escalate Clinical Concerns and Support APC Clinical Decision-Making. Serve as the first clinical escalation point within the pod — triaging member clinical concerns, assessing urgency, and routing to the members PCP, CAW APC or RMO for provider-level intervention when needed. During virtual visits and between encounters, maintain situational awareness of member health status and proactively flag emerging clinical risks before they require emergency intervention.

Facilitate Cross-Disciplinary Care Coordination Across the Pod. Coordinate seamlessly with the members PCP, APCs, Health Coaches, Care Coordinators, Social Workers, and the RMO to ensure each member's care is cohesive and accountable across every role in the pod. 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. Participate in care gap…