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RN Nurse Care Manager
HarmonyCaresNurse Care Manager responsible for managing care of high-risk patients with complex needs in home-based setting. Working collaboratively within care team to enhance patient health outcomes.
About the role
Key responsibilities & impact- The Nurse Care Manager is an integral member of the care team and is vital to enhancing the health outcomes of HCMG patients.
- This position will manage a caseload of high-risk patients where he/she is responsible for managing their care and barriers.
- Coordinates care services with pod leader to ensure that patients have access to a comprehensive set of services tailored to their needs throughout their healthcare journey.
- Works collaboratively within the care team to develop and manage personalized care plans, address care gaps, and engage with other resources to ensure access to care.
- Coordinates the transition of care for patients throughout the continuum to ensure patient needs are met accordingly and to ensure that avoidable hospital admissions do not occur.
- Coordinates and facilitates High Risk Huddles along with ensuring that follow-up actions are completed.
- Prioritizes patients based on the severity and urgency of their conditions to ensure that the most critical cases receive immediate attention.
- Reviews medical records to identify gaps in care and coordinate services with the care team to manage these issues.
- Regularly updates patient care plans.
- Performs thorough nursing assessments via telephone of patients to maximize or improve current health outcomes.
- Provides education to patients and/or their caregivers on disease education, medication, health maintenance, and disease prevention to promote self-management and improve health outcomes.
- Demonstrates strong clinical skills, critical thinking abilities, and effective communication in their interactions with patients, caregivers, providers, fellow care team members, etc.
- Documents necessary interactions, assessments, updates, etc. in patient’s medical records according to processes and guidelines.
- Serves as liaison between patients, providers, resources, etc. to ensure seamless care delivery.
- Facilitates communication of patient status and plan of care during transitional experiences such as home to hospital, hospital to post-acute care and back to home.
Requirements
What you’ll need- Active Registered Nurse License
- 2+ years of care management experience in community, health plan or hospital systems
- Possesses strong clinical skills and proactive thinking
- Effective communication skills
- Ability to perform extensive telephone assessment
- Knowledge of Medicare regulations and home care and hospice standards
- Experience with small group presentations and teaching/training
- Exhibits excellent interpersonal skills
- Exhibits excellent written and oral skills
- Working knowledge of computer programs (email, Word, Excel, PowerPoint, etc.)
- Manages time effectively to ensure all duties and documentation requirements are completed in a timely manner
Benefits
Comp & perks- Quarterly Bonuses
- Health, Dental, Vision, Disability & Life Insurance, and much more
- 401K Retirement Plan (with company match)
- Tuition, Professional License and Certification Reimbursement
- Paid Time Off, Holidays and Volunteer Time
- Paid Orientation and Training
- Day Time Hours (no holidays/weekends)
- Great Place to Work Certified
- Established in 11 states
- Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
care managementnursing assessmentspatient care plansdisease educationmedication managementhealth maintenancecritical thinkingtelephone assessmentdocumentation
Soft Skills
effective communicationinterpersonal skillsproactive thinkingtime managementteam collaborationpresentation skillsteachingwritten communicationoral communication
Certifications
Registered Nurse License