Care Management RN Chronic Care

Shift

Mon-Fri 8am-5pm

Location

Hybrid (Remote but will also include in person clinic rounding and team meetings)

Responsibilities

• Identifies patients not meeting clinical goals and arrange follow-up services by protocol or as appropriate.
• Creates patient, physician, and office-level quality performance reports.
• Conducts pre-visit chart reviews, identifying needed preventive health maintenance, immunizations, and chronic disease interventions.
• Serves as a resource for managing patients and coordinating care across the continuum.
• Acts as a liaison with patients, families, physicians, clinical staff, and other departments, following up after hospital discharge and at clinically appropriate intervals.
• Provides or arranges needed patient education regarding specific healthcare skills and general disease concepts.
• Participates in clinical performance improvement and quality activities, developing measurement and feedback of performance indicators.
• Analyzes clinical and resource data to identify areas needing changes related to clinical, financial, and satisfaction outcomes.
• Manages specific patient populations across the continuum, focusing on complex, high-risk, high-cost, and multi-diagnosis patients.
• Oversees the disease registry database, ensuring it is up to date and arranging follow-up services for patients overdue for visits, labs, or referrals.
• Other duties as assigned.

Requirements

• Effectively communicate with physicians, other health care professionals, patients and/or caregivers required.
• Must have initiative to assume fiscal responsibilities and work autonomously required.

Qualifications

• Associate's of Nursing [Required]
• Bachelor's of Nursing [Preferred]
• Field Of Study N/A
• 3+ clinical hospital experience [Required]

Skills

• Knowledge of healthcare policies and procedures
• Ability to manage multiple tasks simultaneously
• Strong interpersonal and communication skills

Benefits

Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance, Paid Time Off from Day One, 403-B Retirement Plan, Whole Person Well-being Resources, Mental Health Resources and Support, Pet Benefits

Pay

$66,818.30 - $114,689.00

Physical Requirements

View physical requirements