[Hiring] Manager, Case Management @Alignment Health

Role Description

The Remote - 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
• Interdisciplinary Care Team (ICT) delivery for SNP members

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.

Qualifications

• Active, unrestricted California RN license
• Associate’s or Bachelor’s Degree in Nursing
• Minimum 5 years of clinical case management experience
• Minimum 1 year of experience supporting SNP programs within a health plan environment
• Willingness to obtain RN licensure in additional company markets, if needed
• Strong understanding of CMS SNP Model of Care
• Strong understanding of Medicare Advantage regulations
• Strong understanding of care coordination and population health strategies

Requirements

• Lead, coach, and develop a high-performing case management team serving SNP members
• Ensure timely completion of Health Risk Assessments (Initial & Reassessments)
• Ensure timely completion of Individualized Care Plans (ICPs)
• Ensure timely completion of Interdisciplinary Care Team (ICT) activities
• Monitor operational and quality performance metrics and implement improvement strategies
• Oversee regulatory audits, compliance initiatives, and quality assurance activities
• Collaborate cross-functionally with Utilization Management, HEDIS/STARS, Quality Improvement, Provider and Clinical Operations teams
• Analyze reporting trends and operational data to support strategic decision-making
• Promote a culture of accountability, collaboration, and continuous improvement
• Support program growth and operational excellence within the Medicare Advantage SNP population

Benefits

• Fully remote flexibility
• Opportunity to lead and grow within a rapidly expanding organization
• Meaningful work improving outcomes for high-risk Medicare populations
• Collaborative, mission-driven culture focused on quality care and innovation
• Ability to influence and enhance case management programs at scale
• Competitive compensation and benefits package

Physical Requirements

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role.
• Regularly required to communicate effectively via phone and video conferencing
• Frequent sitting, standing, typing, and computer use
• Occasionally lift and/or move up to 10 pounds
• Close vision and ability to adjust focus required for computer-based work