CARE MANAGER-RN

About the Role

The RN Care Manager will provide a systematic organization of care within the Physician Practice and coordinate with other care team members and/or settings. This role focuses on delivering high-quality, patient-centered care management to patients identified through high-risk registries. Responsibilities include developing individualized care plans, coordinating care across the continuum, creating prevention plans, and ongoing monitoring.

The RN Care Manager will lead efforts to ensure the care team is informed of the overall care plan, progress, and patient needs.

Responsibilities

• Document a mutually agreed-upon plan of care based on the patient’s goals, addressing all significant ongoing health problems and risks.
• Provide ongoing assessment, monitoring, and tracking in the Electronic Health Record (EHR).
• Manage care using registry functionality, with interventions triggered by regular review and monitoring.
• Provide proactive care and education outside routine office visits, such as by phone, Patient Portal, or other access activities.
• Build trusting, professional relationships with patients, families, and/or caregivers.
• Utilize self-management and shared decision-making tools.

Requirements

• BSN required.
• Maintain current RN licensure as issued by the State of Ohio Board of Nursing.
• A minimum of three years’ previous nursing experience; leadership role preferred.
• Solid knowledge of chronic conditions, strong assessment, and patient interview skills.
• Demonstrate accurate and timely data and computer skills.
• Excellent written and verbal communication skills.
• Must be self-directed with the ability to work independently.
• Ability to prioritize projects and multi-task as appropriate.
• EPIC knowledge preferred.