Blue Cross Rn Remote Jobs in California (NOW HIRING)

Population Health RN — Clinical Operations Leader

Vigilance Health  |  Remote  |  Full-Time

You\'ve Done This Before. Now Do It at Scale.

You know what it takes to run a remote care management program. You\'ve wrestled with ACO quality measures, figured out why patients aren\'t picking up the phone, and coached a care manager through a tough case at 4pm on a Friday. You\'ve sat in rooms with FQHCs, IPAs, and payers and spoken their language fluently.

Now imagine doing that with the full backing of an organization whose entire mission is built around it — and where your work directly shapes the clinical programs that serve thousands of patients across diverse communities. That\'s what we\'re offering.

Who We Are

Vigilance Health partners with FQHCs, ACOs, IPAs, and payers to deliver Population Health and Care Management services that actually move the needle. We run Care Management, APCM, Remote Patient Monitoring (RPM), and Behavioral Health Integration (BHI) programs — and we measure success the way our partners do: quality metrics, patient engagement, and outcomes that show up in data.

Our purpose is simple, and we mean it: Change People\'s Lives — no matter their circumstances.

The Role

As our Population Health RN, you\'ll be the clinical engine behind our care management programs. This is a leadership role with real ownership — you\'ll build and coach the care management team, design and refine the clinical workflows they follow, and hold the clinical bar high across every service line we run.

You\'ll be working closely with our partners, most of whom are laser-focused on ACO quality measures and patient engagement. When they ask why HEDIS rates are moving or why patients aren\'t scheduling follow-ups, you\'ll be the one with answers — and a plan. This role is remote, and you\'ll be leading a remote team, so your ability to build culture, accountability, and clinical consistency across distance is critical.

What You\'ll Own

Team Leadership

You\'ll recruit, onboard, coach, and develop a team of care managers. You set the standard for what great care management looks like and hold the team to it — with support, not just expectations.

Clinical Workflow Design

You\'ll build and continuously improve the clinical workflows that drive better outcomes. That means protocols that are practical, documented, and actually followed — not binders that collect dust.

ACO Quality & Patient Engagement Performance

Our partners live and die by their quality metrics. You\'ll monitor performance across ACO quality measures, identify where the gaps are, and lead the interventions that close them. Patient engagement is core to everything — including call answer rates, appointment scheduling rates, and no-show reduction. You\'ll understand why those numbers look the way they do and know what levers to pull.

Partner Collaboration

You\'ll be a trusted clinical voice for our partner sites — joining meetings, co-managing escalations, and making sure the clinical work we do is tightly aligned with what partners need to succeed with their payers and regulatory bodies.

Clinical Oversight Across Programs

Care Management, APCM, BHI, RPM — you\'ll ensure clinical standards, regulatory alignment, and documentation quality across all of them.

What Good Looks Like in 12 Months

• Your care managers are hitting productivity targets and delivering high-quality, personalized care.
• ACO quality measure performance is trending up across partner panels.
• Patient engagement rates — calls answered, appointments kept, no-shows reduced — are measurably improving.
• Clinical workflows are standardized, followed, and audit-ready.
• Partners view you as an extension of their clinical leadership team.
• Leadership has clear, real-time visibility into performance, risk, and opportunity.

What You Bring

Experience That Matters Most

• Active RN license (required)
• Experience working in or directly with FQHCs, ACOs, IPAs, or payers — you know how they operate and what they care about
• Deep familiarity with ACO quality measures (HEDIS, UDS, or equivalent) — you can speak to them without looking them up
• Prior leadership of a remote care management program — you\'ve managed remote clinical staff and know how to build accountability at a distance
• 5+ years of clinical experience, with meaningful time in population health or care management
• BSN required; MSN a plus

Nice to Have

• CCM, CPHQ, or population health certification
• Behavioral Health Integration (BHI) experience
• Experience launching or scaling new care management service lines

The Kind of Person Who Thrives Here

You\'re not waiting to be told what to do — you see the gap and start building the solution. You can zoom out to think strategically and zoom in to coach a care manager on a specific patient interaction. You communicate clearly with clinical teams, operations leads, and external partners without losing anything in translation. And when the data doesn\'t look right, you don\'t shrug — you dig in.

Why Vigilance Health

• Direct impact — your work shapes outcomes for real patients in real communities
• Leadership with latitude — we give you room to build programs the right way
• Mission-aligned partners — we work with organizations that care as much as we do
• Growth-oriented culture — solutions-focused, no bureaucracy for its own sake
• A team that has your back — driven, collaborative, and invested in each other

If you\'ve been looking for a role where your population health expertise actually drives the clinical direction of an organization — this is it.

Apply today. Let\'s change lives together.

Vigilance Health is an equal opportunity employer committed to building a diverse, inclusive team.