Registered Nurse Care Manager - Value Based Care (VBC)

Care Advantage Corporate•Richmond, VA

5d•Hybrid

About The Position

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. 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.

Requirements

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)

Nice To Haves

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

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