Job Overview
Location
Remote Arizona
Job Type
Full-time
Category
Product Management
Date Posted
June 18, 2026
Full Job Description
đź“‹ Description
- • Lead, coach, and develop a high-performing case management team serving Medicare Advantage Special Needs Plan (SNP) members.
- • Ensure timely completion of Health Risk Assessments (Initial and Reassessments), Individualized Care Plans (ICPs), and Interdisciplinary Care Team (ICT) activities for SNP members.
- • Monitor and report on operational and quality performance metrics, implementing data-driven improvement strategies to enhance care outcomes.
- • Oversee regulatory audits, compliance initiatives, and quality assurance activities to ensure adherence to CMS Model of Care requirements and Medicare Advantage regulations.
- • Collaborate cross-functionally with Utilization Management, HEDIS/STARS, Quality Improvement, Provider, and Clinical Operations teams to align care delivery and reporting.
- • Analyze reporting trends and operational data to support strategic decision-making and program growth within the SNP population.
- • Promote a culture of accountability, collaboration, and continuous improvement across the care management team.
- • Support program expansion and operational excellence by optimizing care coordination processes for high-risk, chronically ill Medicare populations.
- • Maintain compliance with all state and federal regulatory standards specific to SNP programs and Medicare Advantage plans.
- • Drive member-centered care by advocating for vulnerable populations and ensuring access to comprehensive, coordinated health services.
- • Utilize EHR systems and healthcare technology platforms to manage case loads, track interventions, and report on clinical outcomes.
- • Adapt to a fast-paced, remote work environment while maintaining high standards of communication, organization, and team performance.
- • Willingness to obtain RN licensure in additional company markets as business needs expand.
- • Participate in regular phone and video conferencing to lead team meetings, conduct performance reviews, and coordinate with clinical and operational stakeholders.
- • Perform duties requiring frequent computer use, close vision, and the ability to adjust focus for extended periods.
- • Maintain physical ability to sit, stand, type, and lift or move up to 10 pounds as needed for remote work tasks.
🎯 Requirements
- • Active, unrestricted California RN license
- • Associate’s or Bachelor’s Degree in Nursing
- • Minimum 5 years of clinical case management experience
- • Minimum 1 year of experience supporting SNP programs within a health plan environment
- • Strong understanding of CMS SNP Model of Care, Medicare Advantage regulations, and care coordination strategies
- • Willingness to obtain RN licensure in additional company markets, if needed
🏖️ Benefits
- • Fully remote flexibility
- • Opportunity to lead and grow within a rapidly expanding organization
- • Meaningful work improving outcomes for high-risk Medicare populations
- • Competitive compensation and benefits package
- • Collaborative, mission-driven culture focused on quality care and innovation
- • Ability to influence and enhance case management programs at scale
Skills & Technologies
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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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