Remote Complex Care RN (Must reside in Modesto, CA)

Alignment Healthcare • Modesto, CA

3d • Remote

About The Position

Alignment Health is 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. This position is based in Modesto, California, and candidates must reside in the Modesto area. Working within our innovative Care Anywhere model, you'll collaborate closely with Advanced Practice Clinicians, Care Coordinators, Health Coaches, Social Workers, and Primary Care Providers to deliver proactive, member-centered care in a virtual environment.

Requirements

• Located in Modesto, 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.
• Associate Degree in Nursing (ADN) required
• Active, unrestricted RN license in CA
• Current BLS certification.

Nice To Haves

• Bilingual Spanish
• BSN or higher
• Certified Case Manager (CCM) certification.
• Multi-state RN licensure.
• Experience with Athena EMR and TalkDesk or similar virtual engagement platforms.
• Background in population health, care management programs, or Medicare case management.

Responsibilities

• 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 escalate 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.

Benefits

• Work at the top of your license supporting high-risk populations.
• Be part of an innovative care model transforming senior healthcare.
• Collaborate with a dedicated, multidisciplinary care team.
• Make a direct impact on reducing hospitalizations and improving member outcomes.
• Join a mission-driven organization focused on compassionate, coordinated care

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree