Remote Complex Care RN - Virtual Senior Care Navigator

Alignment Health; Fresno (CA); Remote; USD 86,000 - 129,000; Full time

Job summary

Alignment Health is hiring a Complex Care RN to serve as the clinical quarterback for a panel of high‑risk Medicare Advantage members. This role leverages our Care Anywhere model to deliver proactive, member‑centered care in a virtual environment.

You will collaborate with Advanced Practice Clinicians, Care Coordinators, Health Coaches, Social Workers, and Primary Care Providers to ensure patients receive the right care at the right time, improving outcomes while residing in Fresno, CA.

Qualifications

• Minimum 3 years of RN experience in complex care, care management, transitions of care, or related clinical setting.
• Experience with medically complex, high‑risk populations.
• Experience in Medicare Advantage, managed care, home-based care, or value-based care environments.
• Knowledge of HEDIS, HCC coding, and care gap management.
• Experience with telehealth or virtual care environments.
• Active, unrestricted RN license in CA and current BLS.

Responsibilities

• Manage and coordinate care for medically complex Medicare Advantage members.
• Build trusted relationships with members and caregivers through ongoing virtual engagement.
• Lead transitions of care following hospital, SNF, and inpatient discharges.
• Complete medication reconciliations and monitor changes in clinical status.
• Identify and escalate clinical concerns to the appropriate provider.
• Partner with multidisciplinary teams to ensure seamless, coordinated care.
• Support chronic disease management for conditions including heart failure, COPD, diabetes, and CKD.
• Maintain accurate, timely documentation in Athena EMR.

Skills

RN experience

Care coordination

Telehealth

Education

ADN

BSN preferred

Tools

Athena EMR

TalkDesk

Job description

Alignment Health is hiring a Complex Care RN to serve as the clinical quarterback for a panel of high‑risk Medicare Advantage members. This role leverages our Care Anywhere model to deliver proactive, member‑centered care in a virtual environment.

You will collaborate with Advanced Practice Clinicians, Care Coordinators, Health Coaches, Social Workers, and Primary Care Providers to ensure patients receive the right care at the right time, improving outcomes while residing in Fresno, CA.