Virtual RN – Chronic Care & Clinical Operations Specialist
Job Type: Part-time (20 hours/week)
Location: Philippines (Remote, US hours)
Salary: $7 - $8 per hour
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Overview
We are seeking a highly skilled Virtual Registered Nurse (RN) to support chronic care management (CCM), behavioral health integration, and overall clinical operations. This role will focus on optimizing reimbursement, ensuring compliant documentation, and enhancing patient care through proactive care coordination and population health support.
The ideal candidate has experience working with US-based primary care practices, is highly detail-oriented, and understands chronic care workflows, billing optimization, and patient engagement strategies. This role is critical in helping the practice expand services, improve operational efficiency, and maximize revenue opportunities tied to care management programs.
Key Responsibilities
Chronic Care Management & Billing Optimization- Manage Chronic Care Management (CCM) programs, ensuring all services meet billing and compliance requirements
- Create, update, and maintain monthly care plans in patient charts
- Ensure timely documentation to support maximum reimbursement
- Track and verify time-based CCM activities for accurate billing
- Monitor CCM platforms (e.g., Chronic Care IQ or similar systems) for completeness and accuracy
- Identify gaps in documentation or workflow that may impact reimbursement
- Support implementation and management of Behavioral Health Integration (BHI) programs
- Assist in developing workflows for new service lines tied to value-based care
- Ensure documentation and processes align with payer requirements
- Collaborate with leadership on expanding revenue-generating clinical programs
- Conduct patient outreach calls for care plan follow-up and engagement
- Provide patient education and coaching related to chronic conditions
- Coordinate care between providers, patients, and external services
- Support care navigation and ensure continuity of care
- Prepare and organize patient charts, ensuring accuracy and completeness
- Assist with inbox management, message triage, and routing clinical communications
- Support prior authorizations and insurance coordination
- Upload and manage clinical documents, labs, and external records
- Ensure timely updates to patient records and care plans
- Act as a flexible resource across clinical and administrative functions
- Support areas experiencing workflow bottlenecks or staff overflow
- Assist with intake, scheduling coordination, and general operational needs
- Provide executive-level support to practice leadership as needed
- Active Registered Nurse (RN) license required
- Minimum 3+ years experience working with US-based healthcare practices
- Experience with Chronic Care Management (CCM) programs required
- Strong understanding of primary care workflows and revenue cycle drivers
- Experience with EMR/EHR systems and care management platforms
- Excellent communication and patient engagement skills
- Highly organized with strong attention to detail
- Ability to work independently in a remote environment
- Experience with Behavioral Health Integration (BHI) programs
- Familiarity with Chronic Care IQ or similar CCM platforms
- Experience in concierge, metabolic health, or weight loss clinics
- Background in population health or value-based care models
- Experience supporting practice owners or executive leadership