RN-Clinical Care Nurse/Utilization Review - Remote - Virginia

I’m helping LanceSoft find a top candidate to join their team full-time for the role of RN-Clinical Care Nurse/Utilization Review - Remote - Virginia . You'll elevate patient outcomes and quality performance by driving evidence-based interventions from home. Compensation: USD 33 - 37/hour Location: Remote: United States Mission of LanceSoft: "LanceSoft’s mission is to establish global cross-culture human connections that further the careers of our employees and strengthens the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch." What makes you a strong candidate:

• You are proficient in Utilization review, Telehealth, Patient education, Patient assessment, Nursing.
• You have +3 years experience in Quality improvement, Managed care.
• English - Conversational
• Spanish - Conversational
• Haitian Creole - Conversational

Responsibilities and more: Job Title: RN-Clinical Care Nurse/Utilization review Duration: 3 plus month with possible extension Location: Location: Work From Home (Virginia) Location: Work From Home (Virginia) Shift: M-F 8a-5p (local time) Job Summary The Clinical Care Nurse (RN) is a clinic-based nursing role focused on improving patient outcomes, supporting safe Transitions of Care (TOC), reducing avoidable ED utilization, and driving Medicare Advantage Stars and quality performance. The Clinical Care RN plays a critical role in advancing clinical quality, supporting patients across transitions of care, improving patient outcomes, and contributing to Medicare Advantage Stars ratings by proactively identifying care opportunities, engaging patients and providers, and driving evidence-based interventions. This position balances direct patient education and outreach with data-driven quality improvement efforts. Analyze clinical data and trends from platforms such as Athena EMR and DataHub to identify gaps in care related to HEDIS measures and Transitions of Care and post-hospitalization needs, prioritizing high-impact opportunities. Conduct targeted patient and provider outreach via phone and telehealth visits to close care opportunities, provide tailored education on preventive care, chronic disease management, and medication management.

Required Qualifications

• Bachelor’s degree in Nursing
• Active, unrestricted RN license (state -specific as applicable).
• Minimum of 3 years clinical nursing experience with exposure to transitions of care,

quality improvement, managed care, or population health management.