Registered Nurse Care Manager - Value Based Care (VBC)
EmergencyMD
Hybrid/Remote position. Make a Bigger Impact-Beyond the Bedside At 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 Do As 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 Responsibilities Transition Care Coordination & Post‑Discharge Follow‑Up Conduct telephonic post‑discharge follow‑ups for high‑risk members Review care plans and historical clinical documentation within EMR and PointClickCare prior to outreach Identify gaps in care, barriers to recovery, and opportunities to prevent readmissions Coordinate next steps with clinical and operations teams to address member needs Clinical Performance & Quality Improvement Support targeted initiatives tied to health‑plan performance measures Monitor and positively influence value‑based contract metrics Identify trends and insights at the member level to drive continuous improvement Set and achieve quarterly performance goals Education & Advocacy Educate patients, families, and caregivers to support adherence, self‑management, and recovery Provide 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 partnerships Collaboration & Leadership Partner closely with the Senior Vice President of Value‑Based Care, Director of Population Health, and the broader VBC team Collaborate with internal and external clinical leaders to improve patient outcomes Create visibility across the organization for high‑risk members and their individualized needs Who We're Looking For This role is ideal for nurses who enjoy autonomy, critical thinking, and relationship‑driven care—and who are energized by improving outcomes at scale. Required Qualifications Active Registered Nurse (RN) license in the covered region 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 the surrounding area) Preferred Qualifications Experience in Value‑Based Care, Population Health, Case Management, or Transition Care Coordination Bachelor's degree in nursing or related health field Leadership, management, or program development experience Proficiency 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 • Excellence You'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 & Flexibility Combination of clinical coordination, telephonic outreach, and collaboration Regular travel required; occasional overnight or weekend work may be needed Physical requirements include sitting, standing, lifting up to 10 lbs, and general mobility Workplace 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 #J-18808-Ljbffr
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