Remote Complex Care RN — Telehealth Coordination

Alignment Healthcare; Modesto (CA); On-site; USD 85,696 - 128,543; Full time

Job summary

Alignment Health is seeking a Complex Care Registered Nurse (CCM RN) to own the member journey for high-acuity Medicare Advantage members within a fully virtual pod. You will coordinate care, ensure timely interventions, and monitor clinical status across disciplines.

Responsibilities include transitions of care, medication reconciliation, and proactive outreach while documenting in Athena EMR. This remote role supports multi-market coverage and quality outcomes.

Qualifications

• Minimum 3 years of RN experience in complex care, care management, transitions of care, or related clinical setting.
• Experience in Medicare Advantage, managed care, home-based or value-based care environment with knowledge of HEDIS and HCC coding.

Responsibilities

• Own the member journey and care coordination for high-acuity Medicare Advantage members.
• Manage transitions of care and post-discharge follow-up with medication reconciliation.
• Conduct medication reconciliations and monitor symptoms, adjusting care as needed.
• Escalate clinical concerns and support APC/RMO/provider decision-making.
• Coordinate cross-disciplinary care with PCPs, APCs, Health Coaches, Care Coordinators and Social Workers.
• Document all clinical interactions accurately in Athena within required timeframes.

Skills

Complex Care Coordination

Transitions of Care

Clinical Assessment

Telehealth

Athena EMR

Education

ADN/BSN

Tools

Athena EMR

TalkDesk

Job description

Alignment Health is seeking a Complex Care Registered Nurse (CCM RN) to own the member journey for high-acuity Medicare Advantage members within a fully virtual pod. You will coordinate care, ensure timely interventions, and monitor clinical status across disciplines.

Responsibilities include transitions of care, medication reconciliation, and proactive outreach while documenting in Athena EMR. This remote role supports multi-market coverage and quality outcomes.