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 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 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): - 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 post-discharge 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 - Willing to obtain licensure in other designated states within the first 6 months of employment (licensure fees reimbursed by the company) 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. Pay Range: $79,697.00 - $119,545.00Pay 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 careers@ahcusa.com.

Put your talents to work at PCM! Whether you work in our Home Care, Clinical Research, Impairments, or Catastrophic Care division, you will support our mission to deliver care and other services that enhance the quality of life of our clients. Be a part of our dynamic client-focused team and make a difference in your career! Performs advisory activities to assist a Specialized Services Physician and Clinical Administrator with all the tasks necessary to write medical opinion letters for PCM Home Care clients wishing to add conditions to their white card. QUALIFICATIONS: - Knowledge of the EEOICPA program is strongly preferred - Demonstrates strong verbal, written and interpersonal communication skills. - Strong computer skills. - Speaks, reads, writes, and comprehends English. - Demonstrates time management, organizational skills, and ability to function with minimal direction. - Diligently maintains claimant contact records in Salesforce - Utilize strong phone skills – this role requires extensive time on the phone, but is not considered a Call Center position - Provide exceptional customer service to claimants - Build strong relationships with team members, physicians, and Case Managers. ESSENTIAL FUNCTIONS/AREAS OF ACCOUNTABILITY - Liaising with PCM’s Clinical Operations and Home Care clients regarding prospective new conditions that can potentially be added to a client’s white card - Provide clients with forms needed to assist in collecting records on their behalf as well as filing claims, secure return of signed forms, and follow up as necessary - Request records from treating physicians and providers in support of the claim - Receive and organize medical records - Answer claimant questions regarding the DOL - processes and EEOICPA program and benefits - Work directly with clients and Case Managers to guide them through the DOL process - Follow up with claimants at each step of their DOL authorization process to gauge progress and offer additional guidance - Document all steps in Salesforce and update as applicable - Additional job duties as assigned. The typical base pay range for this role is USD $42,640 - $60,320 per year.Individual base pay depends on various factors, in addition to primary work location, complexity and responsibility of role, job duties/requirements, and relevant experience, skills and other market-based factors. Available Benefits Include - Medical - Dental - Vision - 401(k) - Company Paid Short Term Disability - Flexible Spending Account (FSA) - Health Savings Account (HSA) - Paid Time Off - Voluntary Benefits Please contact Mark Rainey II at or at Mark.Rainey@procasemanagement.com today to learn more about our opportunities where you can make a difference in your own career! Professional Case Management is an Equal Opportunity Employer.

The Americas Clinical Operations Site Lead is responsible for the direct management and performance of doctors, nurses, dentists and pharmacists in a designated region. This role focuses on day-to-day clinical delivery, staff coordination, and local execution of global processes. Site Leads are key enablers of quality care and client satisfaction, maintaining strong alignment with the Market Facing and Program Enablement Teams and supporting consistent, high-performing service delivery. The Americas Clinical Operations Site Lead is responsible for leading and coordinating clinical operations at a specific site within our global clinical team. Acting as the direct manager for the clinicians in the region, the Site Lead ensures high-quality, customer-centric decision-making while fostering an agile, collaborative environment aligned with our global standards. The role is designed within a lean and flat organizational model, avoiding unnecessary supervisory layers, while guaranteeing excellence in service delivery, local alignment, and continuous improvement. Key Responsibilities - Direct line management of on-site clinical staff (medical advisors, case managers, pharmacists, dentists). - Directly lead, coach, and support a team of medical advisors and case managers (nurses and doctors), fostering engagement, professional growth, and accountability. - Ensure staff engagement and professional development at site level - Provide day-to-day oversight of all clinical activities at the site, ensuring delivery of timely, accurate, and high-quality medical decisions. - Ensure seamless coordination with Management Support, Market Facing, and Program Enablement teams, and high‑visibility institutional stakeholders. - Implement quality improvement actions at local level. - Drive initiatives that enhance the experience of insured members and healthcare providers, creating value every day. - Act as the escalation point for complex or high-impact clinical situations. - Foster a strong, agile team culture with a focus on customer-centric outcomes. - Contribute to the identification of operational risks and local process gaps. - Ensure differentiated handling of high-cost and high-utilization cases, safeguarding clinical and financial outcomes. - Navigate complex, high‑sensitivity cases involving internationally mobile populations, and dependents, applying sound clinical judgment, discretion, and cultural awareness. Required Skills & Competencies - Proven ability to lead diverse clinical teams with empathy, clarity, and accountability. - Strong medical background, ideally with globally mobile employee populations - Solid understanding of workflows, metrics, and productivity in clinical operations. - Data savvy with experience in clinical and performance reporting. - Commitment to delivering value and improving daily experience for insured members and providers. - Capacity to thrive in a dynamic, multicultural, and distributed global environment. - Excellent communication skills, with the ability to engage stakeholders at all levels. - Analytical mindset with a focus on pragmatic solutions, automation, and quick wins. - Strong ability to work across sites, hubs, and global teams, building trust and alignment. - Balance between short-term operational delivery and long-term vision for clinical quality and service innovation. Profile Requirements - Bachelor's Degree in Healthcare/Health Services Administration, Nursing, Public Health, Allied Health, or a related field is required. - Strong experience in team management or coordination & 3+ years prior leadership experience in clinical operations or healthcare services is required. - Demonstrated international or multicultural working experience, ideally with global health service models supporting expatriate or internationally mobile populations is preferred. - Fluent in English; a second global language or local language is preferred. - Operational mindset with problem-solving capabilities. Demonstrated success in managing multidisciplinary teams. - Ability to work in a matrixed, multicultural and fast-paced environment. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 94,700 - 157,900 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

• Plan and manage all aspects of clinical trials, ensuring adherence to timelines, budget, and quality standards. • Collaborate with cross-functional teams to establish and implement clinical trial protocols and procedures. • Build and manage strong relationships with trial investigators and stakeholders. • Ensure all trials are conducted in compliance with local, national, and international regulations and ethical guidelines. • Problem-solve and make critical decisions regarding trial design, vendor selection, and risk management.