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Vida Health is seeking a licensed RN or LPN to manage clinical review requests, escalations, and member inquiries in a fully remote virtual care setting. In this role, you will be the clinical operations hub for quality assurance and member support, handling intake, triage, and resolution of clinical cases while maintaining strict service level agreements.
Key responsibilities include reviewing and analyzing patient medical records to extract clinically relevant information for providers and leadership; investigating clinical escalations from members and internal stakeholders (Member Support, Account Management, Clinical Operations); responding professionally to member inquiries within Vida's clinical guidelines; collaborating with providers and clinical assistants to ensure continuity of care; monitoring cases through resolution with timely documentation; identifying trends and process improvement opportunities to support quality assurance initiatives; assisting with provider performance monitoring and operational audits; and maintaining accurate records across all required systems.
You will work with provider messaging platforms, telehealth technologies, and cloud-based tools (Slack, Google Workspace, Zendesk, Zoom, EMR systems) to manage multiple priorities efficiently in a fast-paced environment. This role requires strong clinical judgment, compassionate patient-centered support, and the ability to adapt to evolving workflows and technology platforms.
Qualifications:
- Active RN or LPN license in good standing
- Minimum 2 years of experience in primary care, family medicine, internal medicine, or outpatient clinical setting
- Experience reviewing medical records and clinical documentation
- Strong written and verbal communication skills
- Excellent organizational skills and attention to detail
- Proven ability to analyze situations, identify issues, and implement solutions
- Ability to work independently in a fully remote environment
- Strong computer and technology proficiency
- Proficiency with cloud-based technologies (Slack, Google Workspace, Zendesk, Zoom, EMR, telehealth platforms)
- Ability to navigate multiple systems simultaneously while maintaining accuracy
- Demonstrated ability to manage multiple priorities in a fast-paced setting
- Commitment to compassionate, patient-centered support
- Ability to adapt to evolving workflows and operational processes
Preferred qualifications include experience in telehealth or virtual care environments, utilization management, prior authorizations, clinical review processes, obesity medicine, chronic disease management, population health programs, quality assurance, compliance, clinical operations, care coordination, electronic prescribing systems, and electronic medical records.
