RN Case Manager, Transition of Care - Inpatient (Hybrid Field Remote in Stockton, CA)
RN Case Manager, Transition of Care - Inpatient (Hybrid Field Remote in Stockton, CA)
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$ 85696 - 128543
1 Vacancy
Job Description
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 fastgrowing 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.
Alignment Health is seeking an hybrid field remote RN Case Manager Transitions of Care (TOC) Inpatient in Stockton CA to join the TOC team (with mileage reimbursement.) Responsible for health care management and coordination within the scope of licensure for members with complex and chronic care needs by assessing developing implementing coordinating monitoring and evaluating care plans designed to optimize member health care across the care continuum. Supports Transitions of Care (TOC) to ensure timely access and coordination of follow up care adherence to discharge plans and member education to support improved health outcomes. Coordinates and monitors Alignment Health members progress and services to ensure consistent costeffective care that complies with Alignment policy and all state and federal regulations and guidelines. Performs duties in field and telephonically.General Duties / Responsibilities (May include but are not limited to):
- Supports inpatient program engagement for Alignment members currently inpatient in an acute or skilled nursing facility setting.
- Manages Transitions of Care (TOC) for members moving from inpatient SNF and emergency services to lower level of care facilities or home in accordance with established workflows.
- Manages TOC activities including postdischarge follow up appointment scheduling and monitoring for kept appointments
- Ensures member access to services appropriate to their health needs.
- Identifies assesses and manages high risk/complex members per established criteria and health risk status.
- Develops monitors and evaluates the effectiveness of the care management plans and modifies as necessary to support improved health outcomes.
- Interfaces with Primary Care Physicians Hospitalists Nurse Practitioners and specialists on the development of care management treatment plans.
- Assists in problem solving with providers claims or service issues.
- Measures the effectiveness of interventions to determine case management outcomes.
- Counsels and engages in personal discussions with patients and their families on available care options. Helps them to determine their appropriate and preferred course of action.
Job Requirements:
Required: 3 years of clinical case management experience; or any combination of education and experience which would provide an equivalent background
Preferred: Medicare Advantage Health plan experience
Education/Licensure:
Required:
- Active valid and unrestricted Registered Nursing (RN) license in California (noncompact)
- Willing to obtain licensure in other designated states (Noncompact: NV; Compact: AZ NC TX) within the first 6 months of employment (licensure fees reimbursed by the company)
- Active valid and unrestricted California Drivers License and reliable transportation.
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.
- 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.
- 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.
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.
*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employmentrelated offers in exchange for money or other sensitive personal be advised that Alignment Health and its subsidiaries will never ask you for a credit card send you a check or ask you for any type of payment as part of consideration for employment with our you feel that you have been the victim of a scam such as this please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healths talent acquisition team please email.
Required Experience:
Manager
Employment Type
Full-Time
