Remote Complex Care RN: Virtual Care Coordinator

Alignment Healthcare USA, LLC in; Stockton (CA); Remote; USD 86,000 - 129,000; Full time

Job summary

Alignment Health is seeking a Remote Complex Care Registered Nurse (CA residents) to lead member journey management for high-acuity Medicare Advantage members in a fully virtual pod. The CCM RN coordinates care across disciplines, conducts medication reconciliation, and ensures timely post-discharge follow-up.

The role emphasizes proactive engagement, escalation where needed, and collaboration with APCs, Health Coaches, and social workers to optimize care outcomes and reduce readmissions.

Qualifications

• Minimum 3 years RN experience in complex care/care management.
• Experience with Medicare Advantage, care gap management, HEDIS and HCC coding.
• Telehealth/virtual care delivery experience.
• Strong cross-disciplinary communication and collaboration.

Responsibilities

• Own the Member Journey and Care Coordination for High-Acuity Members.
• Manage Transitions of Care and hospital discharge coordination.
• Complete medication reconciliations and clinical monitoring.
• Escalate clinical concerns and support APC clinical decision-making.
• Facilitate cross-disciplinary care coordination across the pod and caregivers.
• Support HEDIS, quality, and care gap closure activities.
• Manage chronic condition care pathways and GDMT delivery.
• Document all interactions accurately in Athena.

Skills

Complex Care Coordination

Telehealth / Virtual Care

Care Transitions of Care

Medication Reconciliation

HEDIS / Quality Measures

Multi-state Licensure

Education

RN license

ADN/BSN preferred

Multi-state licensure preferred

BLS certification

Tools

Athena EMR

TalkDesk

Job description

Alignment Health is seeking a Remote Complex Care Registered Nurse (CA residents) to lead member journey management for high-acuity Medicare Advantage members in a fully virtual pod. The CCM RN coordinates care across disciplines, conducts medication reconciliation, and ensures timely post-discharge follow-up.

The role emphasizes proactive engagement, escalation where needed, and collaboration with APCs, Health Coaches, and social workers to optimize care outcomes and reduce readmissions.