Manager, Case Management SNP (California RN License Required) [Remote]

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.

Location: Fully Remote – California (Outside Bay Area preferred)
Schedule: Full-Time | Monday–Friday
Department: Case Management

About the Role

We are seeking a dedicated  Manager, Case Management – SNP to lead a team focused on providing high-quality, patient-centered care to members with complex medical needs. This leadership position plays a key role in overseeing our  Special Needs Plan (SNP)program, ensuring compliance with CMS regulations and promoting optimal health outcomes for our members.

As a fully remote leader, you will manage daily operations, support care coordination activities, monitor team performance, and ensure adherence to the Model of Care. This is an exciting opportunity to lead a skilled interdisciplinary team making a real impact in the lives of vulnerable populations.

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 states 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:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential 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.

1. 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.

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