RN Care Navigator: Transitions & Quality Improvement

CenterWell; Chesapeake (VA); On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement plan

Paid time off

Job summary

CenterWell Senior Primary Care in Chesapeake, VA is seeking a Clinical Care RN to support transitions of care, reduce readmissions, and improve Medicare Advantage Star ratings. The role combines patient education, outreach, and data-informed quality initiatives within a clinic setting.

The RN must hold an active RN license (BSN or ADN) and have experience with EHRs like Athena, data tools, and MS Office. Bilingual in English/Spanish is preferred.

Qualifications

• Active, unrestricted RN license (state-specific).
• Associate’s or Bachelor’s degree in nursing (ADN/BSN).
• 3+ years’ clinical nursing experience with transitions of care or population health.

Responsibilities

• Support transitions of care and prevent readmissions in post-discharge patients.
• Conduct targeted outreach via phone, telehealth, and in-clinic visits.
• Educate patients on preventive care and chronic disease management.

Skills

RN license

data analysis

EHR proficiency

bilingual English/Spanish

Education

ADN or BSN

Tools

Athena EMR

DataHub

Compass Rose

SalesForce HealthCloud

Microsoft Office

Job description

CenterWell Senior Primary Care in Chesapeake, VA is seeking a Clinical Care RN to support transitions of care, reduce readmissions, and improve Medicare Advantage Star ratings. The role combines patient education, outreach, and data-informed quality initiatives within a clinic setting.

The RN must hold an active RN license (BSN or ADN) and have experience with EHRs like Athena, data tools, and MS Office. Bilingual in English/Spanish is preferred.