Job Overview
Location
Anywhere in the U.S.
Job Type
Full-time
Category
Product Management
Date Posted
May 22, 2026
Full Job Description
📋 Description
- • Inpatient Review Nurse (Remote) role focused on utilization management for senior and chronically ill patients, ensuring appropriate, cost-effective care while maintaining safety and quality standards.
- • Day-to-day responsibilities include reviewing inpatient admissions, assessing medical necessity, coordinating care with physicians and case managers, generating referrals to ancillary services, documenting interactions in EZ-Cap or case management systems, and participating in multidisciplinary care conferences.
- • Works within Alignment Healthcare’s remote utilization management team, supporting a mission-driven organization dedicated to transforming care for seniors and frail populations through innovation and compassionate service.
- • Opportunity to develop expertise in utilization review, case management, and Medicare guidelines while contributing to patient outcomes and gaining experience in a fast-growing healthcare organization with clear pathways for professional growth.
🎯 Requirements
- • Minimum 3 years of general case management experience
- • Active, valid, and unrestricted LVN or RN license in California (Non-Compact)
- • Two consecutive years of experience using Milliman Care Guidelines for inpatient vs. observation length of stay reviews in a managed care setting
🏖️ Benefits
- • Reimbursement for obtaining LVN/RN licensure in Nevada, Arizona, North Carolina, and Texas upon hire
- • Opportunity to work remotely with a mission-driven organization focused on senior and chronically ill patient care
- • Structured Monday-Friday, 8:00 AM–5:00 PM Pacific Time schedule
Skills & Technologies
About Alignment Healthcare, LLC
Alignment Healthcare is a health insurance company that focuses on providing personalized care for seniors and underserved populations. They operate a value-based care model, aiming to improve health outcomes and reduce costs through integrated care teams, technology, and data analytics. Their services include Medicare Advantage plans, chronic care management, and home-based care. Alignment Healthcare partners with providers and aims to deliver a seamless and high-quality healthcare experience for its members, emphasizing proactive and preventive care to keep individuals healthy and out of the hospital.
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