Registered Nurse Care Manager - Value Based Care (VBC)

Job Description

Job Description

Hybrid/Remote position.  Make a Bigger Impact-Beyond the BedsideAt Care Advantage, we believe nursing is more than tasks and charts-it's about outcomes, advocacy, and meaningful connections. As a Registered Nurse Care Manager, Value‑Based Care, you'll play a critical role in improving health outcomes for high‑risk Medicaid members while helping reduce avoidable emergency department visits and hospital readmissions.This is a role for experienced nurses who thrive on transition care coordination, patient education, and system‑level improvement-and who want to see their clinical expertise translate into real, measurable impact.What You'll DoAs an RN Care Manager in Value‑Based Care, you'll serve as a clinical advocate and coordinator for a panel of high‑risk Medicaid members, partnering with patients, families, caregivers, and interdisciplinary teams to support safe transitions and better long‑term outcomes.Key ResponsibilitiesTransition Care Coordination & Post‑Discharge Follow‑Up Conduct telephonic post‑discharge follow‑ups for high‑risk membersReview care plans and historical clinical documentation within EMR and PointClickCare prior to outreachIdentify gaps in care, barriers to recovery, and opportunities to prevent readmissionsCoordinate next steps with clinical and operations teams to address member needsClinical Performance & Quality ImprovementSupport targeted initiatives tied to health‑plan performance measuresMonitor and positively influence value‑based contract metricsIdentify trends and insights at the member level to drive continuous improvementSet and achieve quarterly performance goalsEducation & AdvocacyEducate patients, families, and caregivers to support adherence, self‑management, and recoveryProvide education and insights to internal clinical and operations teams, including population‑specific initiatives (e.g., diabetes management)Serve as a clinical advocate in cross‑functional and external partnershipsCollaboration & LeadershipPartner closely with the Senior Vice President of Value‑Based Care, Director of Population Health, and the broader VBC teamCollaborate with internal and external clinical leaders to improve patient outcomesCreate visibility across the organization for high‑risk members and their individualized needs Who We're Looking ForThis role is ideal for nurses who enjoy autonomy, critical thinking, and relationship‑driven care-and who are energized by improving outcomes at scale.Required QualificationsActive Registered Nurse (RN) license in the covered regionMinimum 5 years of nursing experienceExperience conducting telephonic post‑discharge follow‑upsStrong clinical judgment, communication, and care coordination skillsCandidate must reside in Virginia (prefer Richmond or the surrounding area) Preferred QualificationsExperience in Value‑Based Care, Population Health, Case Management, or Transition Care CoordinationBachelor 's degree in nursing or related health fieldLeadership, management, or program development experienceProficiency in Microsoft Word, Excel, PowerPoint, and Teams Why Care Advantage?At Care Advantage, our mission is grounded in our core values:Integrity • Compassion • Accountability • Respect • ExcellenceYou'll join a team that values your clinical expertise, supports professional growth, and empowers nurses to influence care beyond individual encounters, helping shape better systems, better experiences, and better outcomes. Work Environment & FlexibilityCombination of clinical coordination, telephonic outreach, and collaborationRegular travel required; occasional overnight or weekend work may be neededPhysical requirements include sitting, standing, lifting up to 10 lbs, and general mobilityWorkplace accommodations are available when appropriate Ready to Lead Change in Healthcare?If you're a nurse who wants to reduce readmissions, improve transitions of care, and make value‑based healthcare work for patients, we'd love to meet you.Apply today and help redefine what nursing impact looks like.Location: 23111, 23112, 23113, 23114, 23116, 23150, 23173, 23219, 23220, 23221, 23222, 23223, 23224, 23225, 23226, 23227, 23228, 23229, 23230, 23231, 23232, 23233, 23234, 23235, 23236, 23237, 23238, 23294, 23831, 23832