Manager, Case Management SNP (California RN License Required)

Alignment Health; Indianapolis (IN); Remote; USD 113,000 - 170,000; Full time

Job summary

Alignment Health is seeking a Manager, Case Management SNP to lead a high-performing team responsible for health care management of complex and chronic members. You will oversee Health Risk Assessments, ICP development, and ICT delivery while ensuring compliance with SNP program requirements.

The role emphasizes coaching, staff development, and analysis of operational data to drive program enhancements across markets.

Qualifications

• RN license active and unrestricted in the state of residence.
• Associate’s or Bachelor’s Degree in Nursing is required.
• California RN license preferred; willingness to obtain licenses in other markets.
• Minimum 5 years of clinical case management experience.
• 2+ years of supervisory or team-lead experience in managed care.

Responsibilities

• Lead and manage a high-performing case management team serving SNP members.
• Ensure timely Health Risk Assessments and ICP development.
• Oversee ICT meetings and monitor program performance and quality.
• Ensure regulatory compliance and quality assurance activities.
• Collaborate with Utilization Management, HEDIS/STARs, and Quality teams.

Skills

CMS SNP Model of Care

Medicare Managed Care Plans

Utilization review criteria

Performance data analysis

Leadership

EHR systems

Project management

Communication

Education

RN license (Active, unrestricted)

Associate or Bachelor’s in Nursing

BSN or MSN

Case Management certification (CCM/ACM)

Tools

EHR systems

Job description

Location

Fully Remote – California (Outside Bay Area preferred)

Schedule

Full-Time | Monday–Friday

Department

Case Management

About the Role

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 Manager, Case Management SNP is responsible for the health care management and coordination of care for members with complex and chronic care needs. Assures compliance with SNP program requirements as outlined in the Model of Care. Monitors activities to support the timeliness of Health Risk Assessment (Initial and Reassessment) completion, Individualized Care Plan (ICP) development and Interdisciplinary Care Team (ICT) delivery for SNP members. Monitors and reports program performance, including vendor performance monitoring if activities are delegated. This position is responsible for the day-to-day operational performance of an integrated health management team while ensuring high-quality care management and adherence to regulatory and compliance standards for the appropriate program lines of business.

Key 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.

Requirements

• Education: Required: Associate’s or Bachelor’s Degree in Nursing (RN)
• Preferred: BSN or MSN
• Experience: Required: 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 state markets
• Preferred: At least 2 years of supervisory or team lead experience in a managed care or health plan setting
• Licensure: Required: Active, unrestricted RN license in the state of residence
• Preferred: Case Management certification (e.g., CCM, ACM)

Skills & Knowledge

• 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

Why Join Us?

• 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

Essential Physical Functions

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range

$113,332.00 - $169,999.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.*