Remote APP: Post-Discharge Care & Care Coordination

Sentara Health; United States; Remote; USD 101,000 - 312,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Paid Time Off

Life Insurance

Educational assistance

401(k)/403(b) with employer match

Parental/military leave

Job summary

Sentara Health in Virginia Beach is seeking an Advanced Practice Provider (APP) to deliver timely, virtual care to patients following hospital discharge. The APP will address clinical needs, support a safe transition, and hand off to primary care and other services.

The role emphasizes rapid assessments, medication reconciliation, and clear documentation. The position offers 100% remote work with a flexible schedule, including a closing shift.

Qualifications

• APP licensure and credentials appropriate for the assigned service area.
• Minimum of five years of clinical experience as an APP in family medicine, emergency medicine, or long-term/post-acute care, including management of medically complex adults and focused virtual assessments.
• Strong communication, organization, care-coordination, and independent decision-making skills.

Responsibilities

• Review discharge records and complete focused assessments, medication reconciliation, and time-limited care plans.
• Manage appropriate lower-risk diagnoses and chronic conditions within program scope.
• Recognize red flags and elevate to emergency, specialty, in-person, or higher-acuity care using established protocols.
• Coordinate referrals and services, including home health, wound care, social work, behavioral health, pharmacy, and durable medical equipment.
• Complete timely documentation, continuity-of-care paperwork, and clear handoffs for tests, referrals, and follow-up needs.

Skills

APP licensure

Clinical experience

Care coordination

Communication

Job description

Sentara Health in Virginia Beach is seeking an Advanced Practice Provider (APP) to deliver timely, virtual care to patients following hospital discharge. The APP will address clinical needs, support a safe transition, and hand off to primary care and other services.

The role emphasizes rapid assessments, medication reconciliation, and clear documentation. The position offers 100% remote work with a flexible schedule, including a closing shift.