Field-Based RN Case Manager: Care Coordination

Oak Street Health, part of CVS Health; New York (NY); Sur place; USD 73 000 - 156 000; Plein temps

Avantages offerts par ce poste

Health insurance

Vision and dental benefits

Paid time off

401K match

Leadership development

Résumé du poste

Oak Street Health is hiring an RN, Case Manager for field-based care in New York. You will lead care coordination, work with PCPs and interdisciplinary teams, and focus on reducing hospital admissions and optimizing transitions of care.

The role requires an active RN license in the assigned state, 6–8 years of nursing experience, and CCM certification (or willingness to obtain). Bilingual abilities and strong communication are valued for community engagement.

Qualifications

• Current RN license in assigned state (required)
• Bachelor degree in nursing preferred
• CCM certification preferred or willing to obtain within 12 months
• 6–8 years nursing experience minimum
• 2+ years in transitional nursing, ER, care coordination, discharge planning, or home health preferred
• Fluency in Spanish or other community languages
• Strong motivational interviewing and patient activation skills
• Comfort with change and high emotional intelligence

Responsabilités

• Manage an assigned caseload of complex patients in a value-based care environment, aiming to reduce admissions and readmissions
• Be accountable for panel metrics on admission, readmission, and transitions of care
• Own care coordination for assigned patients and act as primary point of contact within the care team
• Lead transitions of care and perform post-discharge assessments and medication reconciliation
• Coordinate with PCPs, families, social workers, and care team members to align care plans
• Document key clinical assessments and participate in interdisciplinary care planning meetings
• Provide patient education and support for chronic condition management and transitions of care
• Document visits in the electronic health record and participate in assigned duties

Connaissances

Spanish language fluency

RN licensure

Case management

Motivational interviewing

Time management

Care coordination

Interdisciplinary collaboration

Travel flexibility

Emotional intelligence

US work authorization

Formation

Bachelor's degree in nursing

Certified Case Manager (CCM) certification

Description du poste

Oak Street Health is hiring an RN, Case Manager for field-based care in New York. You will lead care coordination, work with PCPs and interdisciplinary teams, and focus on reducing hospital admissions and optimizing transitions of care.

The role requires an active RN license in the assigned state, 6–8 years of nursing experience, and CCM certification (or willingness to obtain). Bilingual abilities and strong communication are valued for community engagement.