Community Case Manager, RN
Core
Registered Nurse leading hyperfocus case management for highest complexity patients to prevent hospital arrivals and maximize healthy time at home.
Role type
Senior IC Intensive Community Care Manager (RN)
Builds
Comprehensive care plans and field nursing interventions for high-risk ambulatory patients
Domain
Healthcare / Community Health Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Clinical nursing assessment, care plan design, fall prevention screening, social determinants of health (SDoH) assessment, medication monitoring, home visit coordination, multidisciplinary team leadership, patient education, community resource navigation, regulatory compliance
Preferred skills
BSN degree, Compact RN license, Certified Case Manager (CCMC/CMCN), prior community case management experience
Technologies
Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)
Responsibilities
Conduct in-house, facility, and telephonic visits to high-risk patients; perform home visits for field nursing interventions and care plan development; supervise LPNs and coordinate patient discharge; assess caregiver capacity and home environment safety; facilitate multidisciplinary team meetings; connect patients with community and financial resources; monitor quality of Home Health Aide (HHA) visits
Seniority
Senior, hands-on IC with supervisory responsibilities
