Field RN Care Manager: Complex Case Coordination

Oak Street Health, part of CVS Health; Indianapolis (IN); On-site; USD 60,522 - 129,615; Full time

Benefits offered by this job

Sign-on bonus

Job summary

Oak Street Health in Indianapolis seeks an RN Case Manager to lead care coordination for complex patients on a value-based care model. You will align with PCPs, families, and the care team to ensure timely assessments, transitions, and patient education.

This field-based role requires exceptional relationship-building with patients and providers. Requirements include an active RN license in the state, 6–8 years nursing experience, CCM certification (or willingness to obtain within 12 months),

Qualifications

• Current RN license in the assigned state is required; Bachelor degree in nursing preferred.
• Minimum of 6-8 years nursing experience.
• Certified Case Manager (CCM) required, or willingness to obtain within 12 months of hire, unless candidate has 2-3 years of relevant care/case management experience.
• 2+ years experience in transitional nursing, emergency room nursing, care coordination, discharge planning, or home health is strongly preferred.
• Demonstrated skill in motivational interviewing, patient activation, time management, and navigating community resources.

Responsibilities

• Manages an assigned caseload of complex patients in a value-based care environment.
• Drive care coordination and reduce admissions, readmissions and medical utilization.
• Owns overall care coordination for assigned patients and acts as primary point of contact.
• Manage transitions of care episodes including assessments and medication reconciliation.
• Collaborate with PCP, family, Social Worker and other team members to evaluate needs and action plan.
• Document key clinical assessments after admissions and participate in planning meetings.
• Lead in-person interdisciplinary care planning meetings.
• Provide patient education for chronic conditions and transitions of care.

Skills

RN license

CCM certification

Care coordination

Time management

Interdisciplinary collaboration

Patient education

Adaptability

Education

Bachelor's degree in nursing

Job description

Oak Street Health in Indianapolis seeks an RN Case Manager to lead care coordination for complex patients on a value-based care model. You will align with PCPs, families, and the care team to ensure timely assessments, transitions, and patient education.

This field-based role requires exceptional relationship-building with patients and providers. Requirements include an active RN license in the state, 6–8 years nursing experience, CCM certification (or willingness to obtain within 12 months),