Registered Nurse (RN) - Care Manager, Value Based Programs (Full-Time, M-F)

Organization Overview, Mission, Vision, and Values

Our mission is to improve the health of people in the communities we serve through compassionate, high-quality care, prevention, and wellness education. Washington Regional Medical System is a community-owned, locally governed, non-profit health care system located in Northwest Arkansas in the heart of Fayetteville, which is consistently ranked among the Best Places to live in the country. Our 425-bed medical center has been named the #1 hospital in Arkansas for four consecutive years by U.S. News & World Report. We employ 3,400+ team members and serve the region with over 45 clinic locations, the area’s only Level II trauma center, and five Centers of Excellence - the Washington Regional J.B. Hunt Transport Services Neuroscience Institute; Washington Regional Walker Heart Institute; Washington Regional Women and Infants Center; Washington Regional Total Joint Center; and Washington Regional Pat Walker Center for Seniors.

Position Summary

The role of the Value-Based Care Manager reports to the Director of Value-Based Programs. This position is responsible for supporting value-based care initiatives within primary care clinics, ensuring high-quality patient outcomes, efficient care coordination, and alignment with performance-based reimbursement models. This position works collaboratively with providers, care teams, coding, and leadership to implement workflows that improve patient care, identify and close care gaps, and enhance clinic performance in quality and cost metrics.

Essential Position Responsibilities

Care Coordination & Patient Management

• Assess patients' needs, both physical and psychosocial, and develop individualized care plans to address those needs.
• Conduct care management calls to identify and follow-up on care gaps, long-term care management, ER visits, and inpatient stays.
• Perform medication reconciliation and assist in chronic disease management.
• Provide education and support to patients and their families, empowering them to actively participate in their care and manage their health condition, including education for self-management strategies, preventive care, and treatment adherence.
• Facilitate transitional care management (TCM) for recently discharged patients.
• Perform other care and assessment activities as needed, including Medicare annual wellness visits.

Quality Improvement & Value-Based Care Support

• Monitor and report on key quality measures, including HEDIS, Medicare Advantage Star Ratings, ACO benchmarks.
• Partner and