RN Care Manager
Core
Coordinate comprehensive care for patients with multiple chronic conditions by collaborating with primary care providers and interdisciplinary teams to develop and deliver care plans.
Role type
RN Care Manager (Population Health)
Builds
Patient care coordination plans and outcomes for chronic disease management
Domain
Healthcare / Population Health / Chronic Disease Management
Deliverable
client delivery
Required skills
Care coordination, patient outreach (telephonic/in-person), care plan development, community resource referral, EHR proficiency, regulatory compliance (HIPAA)
Preferred skills
Medicare value-based program experience, patient education and engagement, outpatient medical office experience
Responsibilities
Screen and monitor patients with chronic conditions, conduct disease-specific and wellness visits, provide transitional care management post-discharge, collaborate with providers to develop care plans, coordinate referrals to community resources, attend care team meetings
Seniority
Mid-level, hands-on IC