Manager, Case Management SNP (California RN License Required)

Alignment Health

1d • $113,332 - $169,999 • Remote

About The Position

We are seeking a dedicated Manager, Case Management – SNP to lead a team focused on providing high-quality, patient-centered care to members with complex medical needs. This leadership position plays a key role in overseeing our Special Needs Plan (SNP) program, ensuring compliance with CMS regulations and promoting optimal health outcomes for our members. As a fully remote leader, you will manage daily operations, support care coordination activities, monitor team performance, and ensure adherence to the Model of Care. This is an exciting opportunity to lead a skilled interdisciplinary team making a real impact in the lives of vulnerable populations.

Requirements

• Associate’s or Bachelor’s Degree in Nursing (RN)
• Minimum 5 years of clinical case management experience
• Minimum 1 year of experience working with SNP programs in a health plan
• California RN license required
• Willing to obtain an RN license in all of our states markets.
• Active, unrestricted RN license in the state of residence
• Strong knowledge of CMS SNP Model of Care and Medicare Managed Care Plans
• Experience with utilization review criteria (e.g., MCG guidelines)
• Ability to analyze performance data and manage case management programs
• Effective communication, leadership, and project management skills
• Comfortable navigating EHR systems and healthcare technology platforms
• Strong problem-solving and time-management skills

Nice To Haves

• BSN or MSN
• At least 2 years of supervisory or team lead experience in a managed care or health plan setting
• Case Management certification (e.g., CCM, ACM)

Responsibilities

• Lead and manage a high-performing case management team serving SNP members.
• Ensure timely completion of Health Risk Assessments, Individualized Care Plans (ICPs), and Interdisciplinary Care Team (ICT) meetings.
• Monitor program performance, identify trends, and develop strategies for improvement.
• Oversee audits, regulatory compliance, and quality assurance activities.
• Collaborate with departments such as Utilization Management, HEDIS/STARs, and Quality to ensure care continuity and integration.
• Provide coaching, performance reviews, and staff development to support team success.
• Analyze reports and operational data to support decision-making and program enhancements.

Benefits

• Be part of a growing, mission-driven organization that prioritizes member health and regulatory excellence
• Work from anywhere in the U.S. (California preferred)
• Opportunity to shape innovative case management programs that make a difference

What This Job Offers

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