Intensive Community Manager, Complex Care (RN)
Core
Registered Nurse leading complex care case management for high-risk patients to prevent hospital admissions and stabilize care at home.
Role type
Senior IC Registered Nurse (Complex Care Manager)
Builds
Comprehensive care plans and home-based interventions for highest complexity patients
Domain
Healthcare / Community Nursing / Case Management
Required skills
Registered Nurse (RN) license, clinical assessment, care plan design, home visit execution, multidisciplinary team coordination, fall risk assessment, social determinants of health screening, patient education, discharge planning
Preferred skills
Bachelor's degree in nursing (BSN), Compact RN license, Certified Case Manager certification, 1+ years community case management experience
Technologies
Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)
Responsibilities
Conduct in-home and facility visits to assess patients and perform field nursing interventions; Coordinate initial case management assessments and develop individualized plans of care; Supervise LPNs and other team members during patient care and discharge; Collaborate with primary care physicians and community providers to navigate healthcare systems; Monitor quality and frequency of home health agency visits; Educate patients and caregivers on self-management and community resources.
Seniority
Senior, hands-on IC with supervisory responsibilities