Care Management RN — Patient Advocate & Coordinator

Covenant HealthCare; Saginaw (MI); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision

Retirement match

Paid time off

Wellness programs

Tuition reimbursement

Job summary

Covenant HealthCare in Michigan seeks a Care Management Specialist RN to advocate for patients, navigate the healthcare system, and lead care coordination for medically complex children and adults. You will collaborate with PCPs, families, and care teams to ensure high-quality, efficient, and cost-effective care in a primary care and hospital-adjacent setting.

You will document patient progress in the EMR, manage risk assessments, and support self-management.

Qualifications

• RN with a bachelor's degree in healthcare or pursuing within 6 months and 3 years acute care experience
• Current MI RN license to practice in Michigan
• EPIC experience preferred
• 3 years of adult medicine/pediatric-related primary care experience preferred
• Experience with patients who have co-occurring mental health and substance abuse issues

Responsibilities

• Coordinate patient care through ongoing collaboration with PCP, patient/family, and health care team
• Lead continuity of care beyond practice boundaries as appropriate
• Address social determinants of care needs (access, education, psychosocial)
• Manage a caseload of approximately 85 to 120 patients
• Serve as liaison to hospitals, specialists, and post-acute services
• Develop comprehensive individualized plans of care and monitor outcomes
• Perform TOC calls within 2 business days of discharge and coordinate follow-ups
• Maintain documentation in EMR and track outcomes using a registry

Skills

RN licensure

Bachelor's degree in healthcare

EPIC experience

Primary care knowledge

Care coordination

Autonomous practice

Education

RN with BSN or pursuing BSN

Associates degree in nursing (RN)

Tools

EPIC

Microsoft Word

Microsoft Excel

Job description

Covenant HealthCare in Michigan seeks a Care Management Specialist RN to advocate for patients, navigate the healthcare system, and lead care coordination for medically complex children and adults. You will collaborate with PCPs, families, and care teams to ensure high-quality, efficient, and cost-effective care in a primary care and hospital-adjacent setting.

You will document patient progress in the EMR, manage risk assessments, and support self-management.