Registered Nurse Care Coordinator – Chronic Disease

EACH; Campbelltown; On-site; AUD 70,000 - 100,000; Full time

Benefits offered by this job

Diversity & belonging

Supportive & inclusive culture

Flexible work arrangements

Salary packaging up to $15,900 tax‑for

$2,650 meals and entertainment

Employee Assistance Program

Fitness Passport

Job summary

Each is recruiting a Registered Nurse Care Coordinator – Chronic Disease to support people living with long‑term health conditions in community settings across NSW. In this primary care–led program, you will deliver comprehensive chronic disease management, care navigation and patient education, helping people stay well at home and connected to the care they need.

You will assess needs, develop individualised care plans, coordinate referrals, follow up after hospital discharge and collaborate

Qualifications

• Bachelor of Nursing or equivalent required; Division 1 RN registration with AHPRA.
• Minimum 5 years nursing experience in relevant settings.
• Experience in chronic disease management and community health considered a plus.

Responsibilities

• Deliver comprehensive chronic disease management, care coordination and care navigation in community settings.
• Conduct holistic health assessments and develop individualised care plans with patients.
• Support goal setting, self‑management and health education with practical strategies.
• Coordinate referrals to multidisciplinary health, social and community services, including social prescribing.
• Provide follow‑up after hospital discharge and escalate care when deterioration is identified.
• Collaborate with GPs and multidisciplinary teams to support integrated care models.
• Participate in case conferences and clinical huddles to strengthen continuity of care.
• Maintain accurate clinical documentation and contribute to quality improvement.

Skills

Chronic disease management

Care coordination

Care navigation

Holistic assessments

Patient education

Autonomous work

Communication

Education

Bachelor of Nursing or equivalent

Division 1 RN registration with AHPRA

Tools

Clinical software

Job description

Registered Nurse Care Coordinator – Chronic Disease

Join us at Each
For over 50 years, Each has stood beside individuals and communities, helping people live healthier, more fulfilling lives.We put people at the heart of everything we do, surrounding them with a network of care and support that empowers individuals to thrive. Join us and be part of a team that delivers Altogether BetterCare– because when we come together, we create brighter futures for all.

About the program
My Care Partners is a primary care-led program supporting people living with chronic and complex health conditions to stay well at home and connected to the care they need. Working closely with general practices and community partners, the program focuses on coordinated, person-centred care that responds to the whole person– not just their diagnosis.

Your role, your impact
As a Registered Nurse Care Coordinator – Chronic Disease, you will play a pivotal role in supporting people to manage their health, build confidence, and navigate the health system with dignity and choice. Your work will help reduce preventable hospital admissions, strengthen continuity of care, and improve everyday wellbeing for people living with long-term health challenges.

You will:

• Deliver comprehensive chronic disease management, care coordination and care navigation in community settings


• Conduct holistic health assessments and develop individualised care plans in partnership with patients


• Support goal setting and self‑management, providing health education and practical strategies


• Coordinate referrals to multidisciplinary health, social and community services, including social prescribing


• Provide follow-up after hospital discharge and escalate care where clinical deterioration is identified


• Collaborate with GPs and multidisciplinary teams to support integrated, shared-care models


• Participate in case conferencing and clinical huddles to strengthen continuity and quality of care


• Maintain accurate clinical documentation and ensure compliance with professional and organisational standards


• Contribute to quality improvement initiatives and a positive, connected team culture

Who we’re looking for
You are a compassionate and skilled Registered Nurse who enjoys working autonomously while staying closely connected to a multidisciplinary team. You bring curiosity, clinical judgement, and a commitment to person-centred care.

You will bring:

• Experience in chronic disease management and supporting people with complex needs


• Strong assessment, care planning and care coordination skills


• Recent acute care nursing experience in the last 5 years


• A client-centred approach grounded in cultural safety and respect


• Confidence engaging with GPs, practice staff and community partners


• Strong communication, organisation and time‑management skills


• Ability to work independently across community settings and as part of a team

Mandatory requirements:

• Bachelor of Nursingor equivalent


• Division 1 Registered Nurse registration with AHPRA


• Minimum 5 years nursing experience

What will make you stand out:

• Experience in primary or community health settings


• Understanding of the social model of health


• Experience working with culturally and linguistically diverse communities


• Confidence using digital health systems and clinical software

What’s in it for you
At Each you’ll be supported to be your best.

We provide:

• Diversity & belonging – We value all backgrounds, abilities, and identities and are committed to cultural safety


• Supportive & inclusive culture – Work with like‑minded colleagues and leaders who genuinely care


• Balance your way – Flexible work arrangements to support what matters outside of work


• Boost your take-home pay – Salary packaging up to $15,900 tax‑free per year, plus an additional $2,650 for meals and entertainment


• Free, confidential support – Employee Assistance Program for you and your family


• Fitness Passport – discounted access to hundreds of gyms, pools and fitness facilities nationwide

See more Each benefits under the Work with us tab on our website.

Applications Close: Monday 9th November 2026

Our Commitment to Inclusion at Each
At Each, inclusion is at the heart of how we work, connect and care. We’re committed to a workplace where everyone feels safe, respected and able to be themselves. We celebrate diversity in all its forms, including Aboriginal and Torres Strait Islander Peoples, LGBTIQA+ communities, people with disability, people from diverse cultural and faith backgrounds, people with lived and/or living experience and people of all age and genders. Each is a child safe organisation with zero tolerance for child abuse, and we are committed to protecting the safety and wellbeing of all children and young people.