In-Home RN Care Manager — Care Coordination Expert

MyCare Medical Group; Florida; On-site; USD 90,000 - 100,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits

Professional growth and development

Dyad-led interdisciplinary team

Job summary

MyCare Medical in Palm Beach Gardens, FL, seeks a full-time RN Care Manager to deliver care coordination in patients' homes and community settings.

This role focuses on complex medical and social needs, addressing SDOH, developing patient-centered care plans, and coordinating services across the care team.

Offering competitive pay ($90,000–$100,000) and comprehensive benefits, the position supports professional growth within a dyad-led, patient-centered organization.

Qualifications

• Active, unrestricted RN license in Florida.
• Minimum 2 years of nursing experience.
• 1 year in case management or related care settings preferred.
• Experience with Medicare Advantage or medically complex populations preferred.
• Knowledge of Social Determinants of Health (SDOH) and community resources.

Responsibilities

• Conduct comprehensive clinical, environmental, and psychosocial assessments in patients' homes and community settings.
• Identify barriers to care, including housing, food insecurity, transportation, medication access, and social support.
• Develop, implement, and regularly update individualized patient-centered care plans.
• Coordinate care between patients, primary care providers, specialists, social workers, home health agencies, and other team members.
• Connect patients and families with community resources and social services.
• Support transitions of care, hospital discharges, and follow-up appointments to reduce avoidable hospitalizations.
• Educate patients and caregivers on disease management, medications, treatment plans, preventive care, and self-management strategies.
• Monitor patient progress and follow up on identified clinical and social needs.
• IV therapy and medication management
• Laboratory coordination
• Advocate for patients and help overcome barriers
• Maintain accurate documentation of assessments, care plans, interventions, and patient outcomes.
• Collaborate with providers and interdisciplinary teams to ensure coordinated care.
• Promote patient engagement, adherence, and improved outcomes

Skills

Active unrestricted RN license

Minimum 2 years nursing experience

1 year case management/home health

Medicare Advantage/complex populations

Knowledge of SDOH

Care coordination/communication

Travel to patient homes

BLS certification

Florida driver's license/insurance

Job description

MyCare Medical in Palm Beach Gardens, FL, seeks a full-time RN Care Manager to deliver care coordination in patients' homes and community settings.

This role focuses on complex medical and social needs, addressing SDOH, developing patient-centered care plans, and coordinating services across the care team.

Offering competitive pay ($90,000–$100,000) and comprehensive benefits, the position supports professional growth within a dyad-led, patient-centered organization.