Hybrid RN Care Manager, Home-Based Patient Care

HarmonyCares; Okemos (MI); Hybrid; USD 74,000 - 81,000; Full time

Benefits offered by this job

Quarterly bonuses

Health insurance

401K with company match

Tuition reimbursement

Paid time off

Job summary

HarmonyCares is seeking a Nurse Care Manager (RN) to join our hybrid work team in Michigan. The role focuses on high‑risk patient management, care coordination, and education to improve outcomes in home-based primary care.

You will collaborate with executives, pod leaders, and clinical staff to develop and manage patient care plans, coordinate transitions, and drive population health initiatives in a value-based care model.

Qualifications

• Active RN license required
• 2+ years care management experience in health care setting
• Strong clinical and communication skills
• Proficient in telephone assessments and patient education
• Knowledge of Medicare regulations and home-based care standards
• Experience with group presentations/training is a plus
• Proficient in standard computer programs (email, Word, Excel, PowerPoint)

Responsibilities

• Coordinate care services with pod leader to tailor services to patient needs
• Develop and manage personalized care plans; address gaps and engage resources
• Oversee care transitions to reduce avoidable hospital admissions
• Lead High Risk Huddles with follow-up actions
• Prioritize patients by condition severity for timely attention
• Review medical records to identify gaps and coordinate actions
• Document interactions and assessments in the medical record
• Serve as liaison among patients, providers, and resources
• Communicate patient status and care plan during transitions

Skills

Active RN license

Care management

Clinical skills

Communication skills

Telephone assessment

Medicare regulations

Teaching/Training

Time management

Education

BSN or higher

BSN preferred

Tools

MS Office

Electronic Health Records

Job description

HarmonyCares is seeking a Nurse Care Manager (RN) to join our hybrid work team in Michigan. The role focuses on high‑risk patient management, care coordination, and education to improve outcomes in home-based primary care.

You will collaborate with executives, pod leaders, and clinical staff to develop and manage patient care plans, coordinate transitions, and drive population health initiatives in a value-based care model.