Master's degree or higher in Nursing or a related clinical field
2+ years of experience in any of the following:
Telemedicine Care
Minimum 2 years of telephone triage experience
Care Management
Active clinical licensure — any of the following:
Nurse Practitioner (NP) – Ohio
Family Nurse Practitioner (FNP) – Ohio
OR any of the following nationally recognized NP certifications:
Family Nurse Practitioner (FNP)
Nurse Practitioner (NP)
Gerontological Nurse Practitioner (GNP)
Preferred
1+ years of Managed Care experience, especially with Medicaid or Dual Eligible (D‑SNP) populations
Experience working in interdisciplinary care teams
Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures
Background in home‑based care, transitional care, or chronic disease management
Overview Salary 135k
Join our client's innovative healthcare team to deliver virtual, physician‑led care for medically complex Medicaid and Dual Eligible patients across Delaware. This role offers flexibility, autonomy, and the opportunity to help launch a new market focused on proactive, home‑based care that improves patient outcomes and reduces avoidable hospitalizations.
Key Responsibilities
Provide comprehensive care management for medically complex Medicaid and D‑SNP patients through telehealth and remote monitoring
Collaborate with physicians, RNs, social workers, therapists, caregivers, PCPs, managed care organizations, and community partners
Guide patients and caregivers through care transitions, including hospital‑to‑home coordination and advance care planning
Support quality initiatives through accurate clinical documentation, including HCC coding, risk adjustment, and closure of STAR/HEDIS gaps
Contribute to the development of care pathways, workflows, and best practices as the Delaware program expands
Build strong, trusting relationships with patients, families, caregivers, and interdisciplinary team members
Schedule & Shift Details
Participate in a shared 24/7 clinical triage rotation to prevent avoidable emergency department visits and hospitalizations
Numbers & Facts
Location
Ohio, Ohio (Remote)
Skills
Best Practicesunmatched
Chronic Diseaseunmatched
Clinical Competencyunmatched
Clinical Medicineunmatched
Clinical Study Publicationsunmatched
Disease Prevention and Controlunmatched
Emergency Careunmatched
Family Nurse Practitioner (FNP)unmatched
Healthcareunmatched
Healthcare Effectiveness Data and Information Set (HEDIS)unmatched
Hospitalunmatched
Managed Careunmatched
Medicaidunmatched
Medical Codingunmatched
Nurse Practitionerunmatched
Nursingunmatched
Patient Careunmatched
Quality Assuranceunmatched
Quality Metricsunmatched
RMONunmatched
Riskunmatched
Social Workunmatched
Team Playerunmatched
Telehealthunmatched
Telemedicineunmatched
Telephone Triageunmatched
Transitional Careunmatched
🎯
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