Registered Nurse, Remote Telehealth, ER, Emergency Triage, Weekends ChenMed LLCRegistered Nurse, Remote Telehealth, ER, Emergency Triage, WeekendsRichmond, VARemote$64,583–$92,262 / yearThe Registered Nurse, Telehealth is responsible for providing telephonic triage directional patient care advice for general and specific illnesses, health related issues, client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Aids in enhancing the quality and effectiveness of the organization's telehealth practices and professional nursing practice through successful utilization and improvement of outcomes that demonstrate program effectiveness.
Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseVARemote$71,100–$97,800 / yearWork-at-Home Information: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Registered Nurse Care Manager - Value Based Care (VBC) Care Advantage Inc. CorporateRegistered Nurse Care Manager - Value Based Care (VBC)Richmond, VARemoteFull timeKey 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?
Appeals Registered Nurse Wisconsin Physicians Service Insurance CorpAppeals Registered NurseRichmond, VARemoteWe are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin. The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare regulations and policies.
Urgent Care Nurse Practitioner Included Health IncUrgent Care Nurse PractitionerVARemoteWe're seeking board certified Nurse Practitioners licensed in Virginia (multi licensed strongly preferred) with broad clinical expertise and a passion for improving healthcare access and quality. In this role, you'll deliver virtual comprehensive care to patients of all ages across a wide range of conditions, while working closely with our provider and support teams.