Registered Nurse (RN) - Continuum Home Health Case Manager - Multiple Locations

University of Virginia•Charlottesville, VA

5d•$82,992 - $112,632•Hybrid

About The Position

UVA Health’s Continuum Home Health team is redefining what high-level nursing looks like outside the hospital walls. We are an academic home health agency, providing care in the community for 30 years. This role is designed for experienced RNs who value clinical autonomy, meaningful patient relationships, while working primarily from home and serving the community they know best. This is not episodic care. It is longitudinal, relationship driven nursing within one of the nation’s most respected academic health systems. As a Continuum Home Health Case Manager RN, you serve as the clinical anchor for patients transitioning from acute care to home or managing complex conditions in their own environment. You work independently, yet never in isolation, supported by UVA Health’s robust interdisciplinary and academic infrastructure. Your day begins from home, planning visits within your assigned community. You may start with a post-discharge patient requiring complex medication reconciliation, followed by a chronic disease management visit focused on education and symptom monitoring. Throughout the day, you collaborate with physicians and team members, adjusting care plans in real time. The pace is purposeful, the work is deeply personal, and the impact is immediate. UVA Health brings academic medicine into the home, allowing nurses to deliver advanced, patient centered care beyond traditional clinical settings. What sets this role apart: Part of UVA Health’s integrated Home & Transitional Care programs, delivering advanced care to patients aging in place or recovering at home Supported by a nationally recognized academic health system with a strong culture of nursing excellence and professional governance Access to interdisciplinary collaboration and specialty expertise typically found only in large medical centers Participation in innovative care models, including telehealth and remote monitoring initiatives expanding access to care in the home A role that values clinical judgment, independence, and continuity of care rather than volume driven visits.

Requirements

Graduate of an accredited nursing program required.
Bachelor of Science in Nursing required within 5 years of hire.
1 year of Relevant Experience
Licensed to Practice as a Registered Nurse in the Commonwealth of Virginia required.
Valid Virginia Driver’s License required.
American Heart Association (AHA) Health Care Provider BLS certification required.

Responsibilities

Manage a defined caseload of adult patients receiving skilled home health services across your local service area
Perform comprehensive in-home assessments, care planning, and ongoing evaluation
Coordinate care for patients across physicians, therapists, social workers, pharmacists, and acute care teams
Deliver evidence-based nursing care, patient education, and chronic disease management in the home setting
Use clinical judgment to prioritize visits, respond to changing patient needs, and prevent unnecessary hospitalizations
Document and communicate effectively using UVA Health’s integrated clinical systems