Nurse, Care Management

About the Role

The Nurse, Care Management is a compassionate and skilled clinician responsible for coordinating and managing comprehensive care plans tailored to individual patient needs. This role collaborates closely with physicians, interdisciplinary teams, and community resources to ensure seamless, high-quality care delivery across the continuum. The nurse focuses on improving patient outcomes, reducing care fragmentation, and enhancing overall quality of life.

In this role, the nurse will assess physical and psychosocial health, identify gaps in care, and advocate for necessary services. Responsibilities include educating patients and families, facilitating transitions of care, and monitoring progress to adjust plans as needed. Success requires strong clinical judgment, excellent communication skills, and a commitment to patient-centered care.

Responsibilities

• Conduct patient outreach to complete assessments, coordinate care, and provide resources.
• Create, implement, and update individualized care plans for patients enrolled in care management programs.
• Educate patients and families on disease processes, preventive screenings, and health maintenance.
• Maintain accurate and timely documentation of patient encounters, progress, and case notes.
• Facilitate interdisciplinary care team meetings and communicate patient progress, barriers, and care needs to providers, families, and team members.

Requirements

• Bachelor’s degree preferred; four years of related clinical experience required.
• 2-3 years of nursing experience, with at least 1–2 years in care management, case management, utilization management, or care coordination.
• LPN required, RN preferred.

Skills

• Proficiency in Microsoft Office and EMR systems; familiarity with Salesforce preferred.
• Excellent written and verbal communication skills.
• Strong organizational and time management abilities.
• Effective motivational interviewing and telephonic nursing skills.
• Ability to work independently while collaborating within an interdisciplinary team.
• Bilingual (English/Spanish) preferred.

Physical Requirements

This position works under usual office conditions. The associate is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk, and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include the ability to lift up to 50 lbs.

The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Conditions

• Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing.

Travel Requirements

May require travel to off-site clinics, hospitals, or other healthcare settings (0-25%).

Tools & Equipment Used

• Computer and peripherals.
• Standard and customized software applications and tools, and usual office equipment.