Clinical Care Nurse: Transitions & Quality Advocate

CenterWell Senior Primary Care; Greer (SC); Sur place; USD 71 000 - 98 000; Plein temps

Résumé du poste

CenterWell Senior Primary Care in Greer, SC seeks an experienced Clinical Care Nurse (RN) to improve patient outcomes through safe transitions of care and quality initiatives. The role balances patient education, outreach, and data-driven improvement within a clinic setting.

You will collaborate with providers and care teams, focus on Medicare Advantage Stars and HEDIS, and engage patients to support chronic disease management and medication adherence.

Qualifications

• Active, unrestricted RN license (state specific).
• 3+ years' clinical nursing experience with exposure to transitions of care, quality improvement, managed care, or population health management.
• Proficiency with electronic health records (Athena EMR) and data analytics tools.

Responsabilités

• Analyze clinical data and trends to identify gaps in care related to Stars and HEDIS measures and transitions of care.
• Coordinate post-discharge follow-up in alignment with TOC and TCM requirements to prevent readmissions.
• Conduct outreach via phone, telehealth, and in-clinic visits to educate on preventive care and chronic disease management.
• Document outreach and clinical interactions in the medical record per CMS standards.
• Collaborate with interdisciplinary teams to implement evidence-based interventions and optimize workflows.

Connaissances

RN license

3+ years nursing

Communication

Formation

ADN/BSN

Outils

Athena EMR

DataHub

Compass Rose

SalesForce HealthCloud

Microsoft Office

Description du poste

CenterWell Senior Primary Care in Greer, SC seeks an experienced Clinical Care Nurse (RN) to improve patient outcomes through safe transitions of care and quality initiatives. The role balances patient education, outreach, and data-driven improvement within a clinic setting.

You will collaborate with providers and care teams, focus on Medicare Advantage Stars and HEDIS, and engage patients to support chronic disease management and medication adherence.