Registered Nurse Case Manager - East Texas
Core
Lead care management activities and care coordination for complex patients in a value-based care environment to prevent avoidable admissions and ensure care continuity.
Role type
Senior Registered Nurse Case Manager
Builds
Care plans and transitions of care for complex patients
Domain
Healthcare / Value-based care
Required skills
Nursing license, care coordination, transitions of care, patient education, interdisciplinary collaboration, clinical assessments, documentation, motivational interviewing
Preferred skills
Transitional nursing, emergency room nursing, home health, Spanish fluency, community resource navigation
Technologies
Electronic health record
Responsibilities
Manage assigned caseload of complex patients, drive admission and readmission prevention, lead interdisciplinary care planning meetings, perform nursing assessments, educate patients and families, document visits in EHR
Seniority
Senior, hands-on IC