A remote role at Included Health.
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Original listing text, shown exactly as published by the company.
Member Journey Quality, Safety, and Value
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Review charts, calls, messages, and other member interactions to assess quality, safety, and member experience across the care journey, using standardized tools and criteria.
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Apply nursing judgment to identify potential clinical risks, gaps in care, or documentation issues, and escalate concerns to quality and safety leaders as appropriate.
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Help ensure individual visits and touch points follow clinical protocols and support appropriate, affordable utilization (e.g., avoiding unnecessary ER visits and duplication of services).
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Support intake and basic triage of member complaints, grievances, and escalations, documenting clearly and routing high-risk or complex issues to leadership.
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Summarize findings from reviews in clear, concise case notes and reports that help cross-functional partners understand what happened and what needs to improve.
Clinical Oversight of Integrated AI Tools
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Use AI-enabled tools (e.g., AI-assisted QA, documentation review, signal detection) in daily work, following established policies and guardrails for safety and privacy.
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Review AI-generated flags, summaries, or recommendations for clinical accuracy, appropriateness, and member-centric tone, and escalate any safety or accuracy concerns.
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Identify and document patterns in AI behavior (false positives/negatives, unclear suggestions, member risk) and share them with the quality and safety team for system-level improvement.
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Participate in testing and feedback for new or updated AI tools and workflows, providing a frontline nursing perspective on safety, usability, and member impact.
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Help ensure that integrated AI tooling supports, rather than replaces, sound nursing and clinical judgment in the member journey.
Data, Reporting, and Improvement Support
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Assist with data collection and basic analysis for quality and safety work (e.g., tracking escalations, coding themes from reviews, updating simple dashboards or logs).
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Support preparation of materials for audits, reviews, and quality improvement initiatives (e.g., curated case examples, summary tables, slide inputs).
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Share observed patterns in member journey quality, safety, and AI performance with leadership to help prioritize improvement opportunities.
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Participate, as requested, in root cause discussions and follow-up planning, bringing a member-focused nursing perspective to proposed changes.
Collaboration and Professional Growth
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Collaborate with the Clinical Quality and Safety team, clinical operations, and other partners to support a consistent, reliable member journey across services and channels.
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Communicate clearly and professionally in written and verbal formats (e.g., investigation notes, email, chat, meetings) with clinicians, leaders, and cross-functional teams.
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Maintain current knowledge of clinical quality, patient safety, and virtual care best practices, as well as organizational policies related to AI-enabled workflows.
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Uphold HIPAA, security, and privacy standards at all times and model Included Health values, including humility, curiosity, and a commitment to equitable, high-quality care.
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Registered Nurse (RN) in good standing with a state nursing board.
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BSN required.
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Typically 1–3 years of clinical nursing experience, preferably in primary care, care management, or outpatient/ambulatory settings.
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Interest in or exposure to clinical quality, patient safety, or care operations; formal prior quality role is a plus but not required.
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Comfortable working with technology and AI-enabled tools, including EHRs, virtual care platforms, and basic reporting/dashboards (e.g., spreadsheets, Looker or similar tools).
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Strong written and verbal communication skills; able to explain clinical concepts clearly to both clinical and non-clinical audiences.
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Curious, systems-oriented, and able to see how individual visits and touch points connect into the broader member journey.
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Self-directed and reliable in following standardized workflows, with good judgment about when to seek guidance or escalate concerns.
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Comfortable working in a fast-paced, virtual environment with changing priorities.
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This is a remote role, requiring a reliable high-speed internet connection.
Included Health
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85 open roles on Sydicom
Included Health is a virtual care and healthcare navigation company that connects members to medical and behavioral health specialists. They offer integrated digital health solutions designed to simplify access to high-quality care and improve health outcomes.
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