Field-Based RN Care Manager for Senior Health

MATTER; Atlanta (GA); On-site; USD 85,000 - 100,000; Full time

Benefits offered by this job

Health insurance

HSA options

Employer-paid life and disability

Supplemental insurance plans

In-person and virtual care services

401(k) with company match

CME allowance

Paid Time Off

Volunteer Days

Job summary

Matter Health is seeking a Registered Nurse (RN) Care Manager to join our field-based care team serving older adults in affordable housing communities across Georgia. You will work closely with Nurse Practitioners and an interdisciplinary care team to deliver coordinated, relationship-focused care and help patients navigate chronic conditions, transitions of care, and access to resources.

This role emphasizes independent work, strong patient relationships, and education to empower patients.

Qualifications

• Active, unrestricted RN license.
• Minimum of 3 years of RN experience.
• Experience working independently in community, home-based, or field settings preferred.
• Experience in care management, primary care, value-based care, home health, or chronic disease management preferred.
• Strong communication, organization, and relationship-building skills.
• Passion for serving older adults and improving healthcare access.
• Comfortable working independently while collaborating with an interdisciplinary care team.
• Experience with electronic health records (EHRs) and healthcare technology.
• Valid driver’s license and reliable transportation.

Responsibilities

• Conduct comprehensive nursing assessments in patients’ homes and community settings.
• Partner with Nurse Practitioners and Medical Directors to support high-risk and rising-risk patients.
• Coordinate care with specialists, primary care providers, hospitals, health plans, and community organizations.
• Educate patients on chronic disease management, medication adherence, preventive care, and healthy lifestyle choices.
• Support patients through transitions of care following hospitalizations or emergency department visits.
• Help identify and close quality care gaps through patient outreach, education, and care coordination.
• Reinforce care plans developed by providers while documenting barriers and follow-up needs.
• Build trusted, long-term relationships with patients and their families.
• Document patient interactions and care activities using Athena, Salesforce, and other technology platforms.

Skills

Active RN license

3+ years RN experience

Independent/community work

Care management experience

Strong communication

Patient-centered care

EHR experience

Driver's license

Education

RN education background

Tools

Athena

Salesforce

Job description

Matter Health is seeking a Registered Nurse (RN) Care Manager to join our field-based care team serving older adults in affordable housing communities across Georgia. You will work closely with Nurse Practitioners and an interdisciplinary care team to deliver coordinated, relationship-focused care and help patients navigate chronic conditions, transitions of care, and access to resources.

This role emphasizes independent work, strong patient relationships, and education to empower patients.