Remote Complex Care RN — Virtual Care Coordinator Lead

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

Job summary

Alignment Health is seeking an Complex Care Registered Nurse (CCM RN) to lead the member journey in a fully virtual care pod. The CCM RN coordinates across disciplines to ensure timely, proactive care for high-acuity Medicare Advantage members.

The role emphasizes transitions of care, medication reconciliation, and cross-disciplinary collaboration to prevent readmissions and support safe community care. Telehealth engagement is central to the position.

Qualifications

• Coordinate care for high-acuity Medicare Advantage members.
• Ensure timely care transitions and post-discharge follow-up.
• Document care activities accurately in the EMR and CMS-compliant systems.

Responsibilities

• Own the member journey and care coordination for a high-acuity panel.
• Manage transitions of care from hospital discharge to community.
• Perform medication reconciliations and monitor clinical status.
• Escalate clinical concerns and support decision-making.
• Coordinate with PCPs, APCs, Health Coaches, and social workers.

Skills

Complex care coordination

Transitions of care

Clinical assessment

Telehealth engagement

Athena EMR

Cross-disciplinary communication

HEDIS/quality awareness

Education

Associate Degree in Nursing (ADN)

BSN preferred

Tools

Athena EMR

Job description

Alignment Health is seeking an Complex Care Registered Nurse (CCM RN) to lead the member journey in a fully virtual care pod. The CCM RN coordinates across disciplines to ensure timely, proactive care for high-acuity Medicare Advantage members.

The role emphasizes transitions of care, medication reconciliation, and cross-disciplinary collaboration to prevent readmissions and support safe community care. Telehealth engagement is central to the position.