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.

Responsible for health care management and coordination within the scope of licensure for members with short term chronic care needs based on care plan provided by providers implementing, coordinating, monitoring care plans designed to optimize member health care across the care continuum. Coordinates and monitors Alignment Healthcare member’s progress and services to ensure consistent cost effective care that complies with Alignment policy and all state and federal regulations and guidelines. Performs duties mostly telephonically.

General Duties/Responsibilities (May include but are not limited to): 

• Ensures member access to services appropriate to their health needs.
• Identifies, assesses and manages members per established criteria.
• Review and implement care plan and provide education materials as necessary with members.
• Interfaces with Primary Care Physicians, Nurse Practitioners, RN case managers and specialists for coordination of care for members.
• Assists in problem solving with providers, RN case managers or service issues.
• Measures the effectiveness of interventions to determine case management referrals and outcomes.
• Participates and provides feedback in the development of utilization/care management policies and procedures.
• 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.
• Providing follow up and implement care plan based on Nurse Practitioner

SUPERVISORY RESPONSIBILITIES:

None

Minimum Requirements: 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Experience:

5 years of clinical case management experience; or any combination of education and experience, which would provide an equivalent background.

Education/Licensure:

Current, unrestricted LVN license in the state for which you are applying

Associate degree preferred

Other:

N/A

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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 Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. 

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected]. 

Pay Range: $70,823.00 - $106,234.00

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.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please 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 company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].