Clinical Care RN: Transitions & Quality Impact

CenterWell Senior Primary Care; Peoria (AZ); On-site; USD 71,000 - 98,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

CenterWell Senior Primary Care seeks a Clinical Care Nurse (RN) to support safe transitions of care, reduce avoidable ED utilization, and drive Medicare Advantage Stars and quality performance. This clinic-based role focuses on improving patient outcomes across transitions of care, with locations including CW Peoria and other centers.

The ideal candidate will have an active AZ RN license (ADN or BSN), 3+ years in clinical nursing, and experience with Athena EMR/DataHub.

Qualifications

• RN with ADN or BSN and active AZ license.
• 3+ years of clinical nursing experience with exposure to transitions of care or population health.
• Proficiency with electronic health records and data analytics tools; MS Office proficiency.

Responsibilities

• Analyze clinical data to identify gaps in care related to Stars and HEDIS measures.
• Coordinate timely post-discharge follow-up to prevent readmissions and EDUtilization.
• Conduct outreach by phone, telehealth, and in-clinic visits to educate on preventive care and chronic disease management.
• Collaborate with interdisciplinary teams to implement evidence-based interventions.

Skills

Clinical nursing

Transitional care coordination

Data analysis

Communication skills

Motivational interviewing

Education

ADN or BSN

Tools

Athena EMR

DataHub

Compass Rose

Salesforce HealthCloud

Microsoft Office

Job description

CenterWell Senior Primary Care seeks a Clinical Care Nurse (RN) to support safe transitions of care, reduce avoidable ED utilization, and drive Medicare Advantage Stars and quality performance. This clinic-based role focuses on improving patient outcomes across transitions of care, with locations including CW Peoria and other centers.

The ideal candidate will have an active AZ RN license (ADN or BSN), 3+ years in clinical nursing, and experience with Athena EMR/DataHub.