Chronic Disease Care Manager - RN

ArchWell Health; Kansas City (MO); On-site; USD 85,000 - 110,000; Full time

Job summary

ArchWell Health is seeking a Chronic Disease Management Nurse to provide comprehensive care management for patients with complex chronic conditions. The role emphasizes patient-centered, culturally sensitive care and collaboration with the care team to meet performance standards and regulatory requirements.

The nurse will assess diverse patient needs, develop and monitor individualized care plans, and educate patients to enhance self-care and adherence.

Qualifications

• Associate degree in Nursing required.
• BSN or related field preferred.
• Active RN license in State of employment required.
• Willingness to obtain RN license in other states with ArchWell Health centers.
• Minimum 2 years clinical work experience required.
• Minimum 2 years case management experience in acute or ambulatory settings required.
• Minimum 1 year disease management experience required.
• CCMC/CMCN certification preferred or willingness to obtain.

Responsibilities

• Assess physical, functional, social, psychological, environmental, learning and financial needs of patients.
• Create and implement care plans to manage complex chronic conditions.
• Monitor progress and reassess goals as needed.
• Provide intensive disease state education and support.
• Collaborate with the Social Worker to address SDOH needs.
• Coordinate safe discharge planning with care team.
• Willing to travel locally to ArchWell Health centers to collaborate with PCPs.

Skills

Chronic disease knowledge

Communication skills

Organization skills

Team collaboration

Independent work

Education

Associate degree in Nursing

BSN preferred

RN license active in-state

Tools

Microsoft Office

EMR knowledge

Job description

ArchWell Health is seeking a Chronic Disease Management Nurse to provide comprehensive care management for patients with complex chronic conditions. The role emphasizes patient-centered, culturally sensitive care and collaboration with the care team to meet performance standards and regulatory requirements.

The nurse will assess diverse patient needs, develop and monitor individualized care plans, and educate patients to enhance self-care and adherence.