Hybrid Remote Care Manager – Chronic Care & Outcomes

Academic Medical Group Inc; Tampa (FL); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Academic Medical Group Inc. is seeking a Care Manager to support high‑risk patients in ambulatory settings, collaborating with multidisciplinary teams to close care gaps and optimize population health outcomes.

The role blends remote and on‑site work, emphasizing health coaching, chronic care management, and effective care transitions. Ideal candidates will have an Associate’s Degree in Nursing, RN licensure, and 5+ years in healthcare, with proficiency in Epic or Cerner and strong communication

Qualifications

• Associate’s degree in nursing and RN licensure required.
• Experience in chronic care management or case management preferred.
• Knowledge of chronic disease guidelines, care coordination, and social determinants of health.

Responsibilities

• Assess high-risk patients via AWVs and CCM evaluations to identify care gaps.
• Provide clinical health coaching to support self-management of chronic conditions.
• Evaluate social determinants of health and connect patients to resources to reduce risks.
• Develop individualized multidisciplinary plans of care to prevent avoidable events.
• Coordinate transitions of care with referrals and follow-ups.
• Collaborate with PCP offices, ACO partners, and managed care staff on population health goals.
• Apply risk adjustment to stratify patient panels.
• Document in the EHR and maintain productivity.
• Use motivational interviewing to support health behaviors.
• Work remotely and on-site with care teams.

Skills

Chronic disease management

Risk stratification

Care coordination

Motivational interviewing

EHR proficiency

Communication skills

Education

Associate’s Degree Nursing

Tools

Epic

Cerner

Job description

Academic Medical Group Inc. is seeking a Care Manager to support high‑risk patients in ambulatory settings, collaborating with multidisciplinary teams to close care gaps and optimize population health outcomes.

The role blends remote and on‑site work, emphasizing health coaching, chronic care management, and effective care transitions. Ideal candidates will have an Associate’s Degree in Nursing, RN licensure, and 5+ years in healthcare, with proficiency in Epic or Cerner and strong communication