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Population Health Rn Jobs in Delaware (NOW HIRING)

Amedisys, Inc.

$85K - $95K/yr

Overview Full-time - Western Sussex County Make a difference every day as an Amedisys Home Health Registered Nurse Join Amedisys-one of the largest and most trusted home health and hospice companies ...

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Population Health Rn information

What is a Population Health RN?

A Population Health RN is a registered nurse who focuses on improving the overall health outcomes of specific groups or populations. Their role involves assessing health trends, coordinating care, educating patients, and implementing strategies to prevent disease and promote wellness on a community level. Unlike traditional bedside nursing, Population Health RNs work across healthcare settings, often analyzing data and collaborating with other professionals to address social determinants of health and reduce health disparities. They may work in hospitals, community organizations, public health agencies, or health systems to design and evaluate population-based programs.

How does a Population Health RN typically collaborate with interdisciplinary teams to improve patient outcomes?

A Population Health RN works closely with physicians, social workers, care coordinators, and other healthcare professionals to identify at-risk patient populations, develop care plans, and ensure continuity of care. Collaboration often involves regular team meetings, case reviews, and leveraging health data to target interventions. By coordinating resources and sharing insights across disciplines, Population Health RNs help drive preventive care initiatives and improve overall health outcomes for communities. This teamwork is essential for addressing complex health needs and reducing hospital readmissions.

What are the key skills and qualifications needed to thrive as a Population Health RN, and why are they important?

To excel as a Population Health RN, you need a solid background in nursing, care coordination, and data-driven health assessment, typically supported by a nursing degree and RN licensure. Familiarity with population health management software, electronic health records (EHRs), and quality improvement frameworks is important. Outstanding communication, critical thinking, and the ability to build relationships with diverse patient populations are key soft skills. These competencies are vital for improving health outcomes, managing chronic conditions, and reducing healthcare disparities across communities.

What is the role of a population health RN in population health?

A population health RN focuses on improving health outcomes for specific populations by analyzing data, developing care plans, and coordinating services to address social determinants of health. They often work in community settings, hospitals, or clinics, utilizing skills in care management, health education, and data collection to promote preventive care and reduce health disparities.

What are popular job titles related to Population Health Rn jobs in Delaware?

For Population Health Rn jobs in Delaware, the most frequently searched job titles are:

What job categories do people searching Population Health Rn jobs in Delaware look for?

The top searched job categories for Population Health Rn jobs in Delaware are:

What cities in Delaware are hiring for Population Health Rn jobs?

Cities in Delaware with the most Population Health Rn job openings:

Population Health Rn jobs near you
Infographic showing various Population Health Rn job openings in Delaware as of September 2026, with employment types broken down into 9% As Needed, 64% Full Time, and 27% Part Time. Highlights an 100% In-person job distribution.

RN / REGISTERED NURSE - ANNUAL WELLNESS VISIT NURSE

Lewes, DE • On-site

Beebe Healthcare
Health Care and Social Assistance • 1 - 5K employees
Learn more about Beebe Healthcareexternal

$62.70/hr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 5 days ago

Beebe Healthcare rating

6.3

Company rating: 6.3 out of 10

Based on 49 frontline employees who took The Breakroom Quiz

Job description

Why Beebe?
Become part of the Beebe team-an inclusive, mission-driven organization located in a vibrant coastal community. At Beebe, you'll build a rewarding career while making a meaningful impact on the health and well-being of our patients. Join a team committed to excellence, collaboration, and compassionate care, and experience the fulfillment that comes from supporting a community that trusts and values the work you do every day.
In addition to competitive compensation and wellness benefits (medical, dental, vision and prescription) Beebe Healthcare also offers:
  • Sign-on and Referral Bonuses for select positions
  • Tuition Assistance up to $5,250
  • Paid Time Off
  • Long Term Sick accrual
  • Employer Contribution Plan
  • Free Short and Long-Term Disability for Full Time employees
  • Zero copay for drugs on prescription plan for certain conditions
  • College Bound 529 Savings Plan
  • Life Insurance
  • Beebe Perks via WorkAdvantage
  • Employee Assistance Program
  • Pet Insurance

Overview
The Annual Wellness Visit (AWV) Nurse plays a key role in supporting preventive care and population health initiatives within the primary care setting. Working collaboratively with the primary care team, as well as members of the care delivery and population health teams, the AWV Nurse is responsible for identifying patients eligible for Annual Wellness Visits and independently completing these comprehensive assessments.
In this role, the nurse conducts the full Annual Wellness Visit efficiently and thoroughly, focusing on preventive health, patient education, and early identification of risk factors. The AWV Nurse provides guidance on wellness and prevention strategies, connects patients with appropriate care coordination resources, and leverages community programs to promote overall health and reduce avoidable hospital readmissions and unnecessary emergency department visits.
This position is ideal for a proactive, detail-oriented nurse who is passionate about preventive care, patient engagement, and improving outcomes across diverse patient populations.
Responsibilities
  • Annual Wellness Visit (AWV) Delivery
    • Follow all AWV protocols and standing orders, including completing required preventive services.
    • Independently conduct comprehensive Annual Wellness Visits for eligible patients.
    • Develop and maintain knowledge of AWV eligibility criteria and documentation requirements.
    • Build expertise in Medicare preventive services and clinical guideline recommendations.

    Quality Measures & Documentation
    • Identify and address open quality gaps with patients, working collaboratively toward closure of those gaps.
    • Document care accurately in the electronic health record (EHR) to reflect completed preventive measures and closed gaps.
    • Complete patient encounter forms at the conclusion of each visit.
    • Report outstanding, abnormal, or urgent findings to the provider immediately.

    Collaboration & Workflow Support
    • Work collaboratively with clinical teams to deliver AWVs efficiently for both patients and staff.
    • Support scheduling efforts, including filling open appointment slots, to meet AWV volume goals.
    • Refer appropriate patients to care coordination resources to improve health outcomes.

    Patient Education & Communication
    • Identify patient education needs and provide guidance on preventive care, wellness, and treatment plans.
    • Communicate clearly and compassionately to engage patients in achieving their health goals.

    Administrative & Compliance Responsibilities
    • Maintain accurate and organized patient treatment records and documentation.
    • Comply with HIPAA and all confidentiality standards.
    • Maintain patient, team member, and employer confidentiality.
    • Perform all other duties as assigned within the scope of the role

Qualifications
  • Required: Two (2) or more years clinical nursing experience with 1 year in an outpatient setting. Experience with Medicare Annual Wellness Visits as well EHR experience.
  • Ability to work independently and exercise sound clinical judgment when interacting with physicians, payors, patients, and families
  • Strong ability to prioritize multiple tasks and responsibilities effectively.
  • Proficient in computer use and electronic medical records.

Credentials
  • Active RN License - State of Delaware or Compact State
  • BLS - Basic Life Support (AHA)

Education
  • Graduate of an accredited nursing school
  • Bachelor's degree preferred

Entry
USD $38.00/Hr.
Max
USD $62.70/Hr.

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