RN Care Manager, Value-Based Care | Hybrid/Remote

EmergencyMD; Richmond (VA); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Care Advantage is seeking an experienced RN Care Manager, Value‑Based Care, to coordinate transitions for high‑risk Medicaid members and partner with clinicians to enhance outcomes and reduce avoidable readmissions.

In this hybrid/remote role, you will conduct telephonic follow‑ups, educate patients and families, monitor quality metrics, and collaborate with the VBC leadership to drive system‑level improvements.

Qualifications

• Active RN license in the covered region (Virginia).
• Minimum 5 years of nursing experience.
• Experience conducting telephonic post‑discharge follow‑ups.
• Strong clinical judgment, communication, and care coordination skills.
• Candidate must reside in Virginia (prefer Richmond or surrounding area).

Responsibilities

• Transition Care Coordination & Post‑Discharge Follow‑Up: telephonic follow‑ups, review care plans in EMR, identify gaps, coordinate next steps.
• Clinical Performance & Quality Improvement: support health‑plan performance metrics, monitor value‑based contract metrics, drive continuous improvement.
• Education & Advocacy: educate patients and families, provide insights to internal teams, support population-specific initiatives.
• Collaboration & Leadership: partner with VBC leadership, collaborate with clinical leaders to improve outcomes, create visibility for high‑risk members.

Skills

Active RN license

5+ years nursing experience

Telephonic follow-up

Clinical judgment

Care coordination

Virginia resident

Education

Bachelor's degree in nursing or related health field

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Microsoft Teams

Job description

Care Advantage is seeking an experienced RN Care Manager, Value‑Based Care, to coordinate transitions for high‑risk Medicaid members and partner with clinicians to enhance outcomes and reduce avoidable readmissions.

In this hybrid/remote role, you will conduct telephonic follow‑ups, educate patients and families, monitor quality metrics, and collaborate with the VBC leadership to drive system‑level improvements.