Remote Manager, Care Management (CA RN Unrestricted License)

About the role

The Manager, Case Management position at Alignment Health is a dynamic and experienced role designed to lead a high-performing team of clinical professionals. This fully remote leadership role focuses on driving excellence in outpatient case management, ensuring high-quality care delivery, regulatory compliance, and optimal resource utilization across the continuum of care.

Responsibilities

• Lead, mentor, and develop a team of RN Case Managers, ensuring alignment with organizational policies and regulatory standards
• Oversee daily outpatient case management activities, including referrals, transitions of care, and care coordination
• Maintain audit readiness by coordinating chart reviews and monitoring case management processes
• Train and onboard new staff while providing ongoing coaching and performance feedback
• Assign and prioritize team workload to ensure efficiency and quality outcomes
• Collaborate cross-functionally with Medical Directors, Quality, and Compliance leadership
• Manage escalated cases and step in to perform case management duties as needed
• Ensure accurate and compliant documentation across all team activities
• Analyze and report clinical and program data to leadership to support continuous improvement
• Support the development and implementation of protocols, workflows, and best practices

Requirements

• 5+ years of RN Case Management experience (or equivalent combination of education and experience)
• At least 1 year of leadership or supervisory experience in a healthcare setting
• Associate’s or Bachelor’s degree in Nursing required
• BSN or MSN preferred
• Licensure: Active, unrestricted Registered Nurse (RN) license (required)
• CCM certification preferred

Key Skills & Expertise

• Strong knowledge of Medicare Managed Care Plans
• Proven leadership and team management experience
• Ability to manage projects and initiatives to improve performance
• Skilled in organizing, prioritizing, and delegating work
• Excellent communication and collaboration skills across diverse teams
• Strong analytical, problem-solving, and decision-making abilities
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Ability to interpret and analyze clinical and statistical reports

Work Environment & Requirements

• Fully remote role (U.S.-based)
• Must be able to work PST hours
• Able to manage multiple priorities in a fast-paced environment