Nurse Care Manager

Solace Medical Care PLLC; United States; Remote; USD 77,000 - 89,000; Full time

Job summary

Honest Health in the United States seeks a Nurse Care Manager to coordinate care for patients with complex chronic conditions from a remote setting. You will partner with physicians, APPs, and care teams to build care plans that improve outcomes and reduce preventable utilization.

Required: active RN license in NY or MI, strong virtual engagement skills, experience with EHRs and Microsoft Office. Base pay ranges from $76,600 to $88,900 with incentives and benefits.

Qualifications

• Must have reliable internet for remote work.
• Active RN license in NY or MI.
• Willing to obtain additional state licenses as needed.
• Experience engaging patients virtually via phone, text, video, etc.
• BSN preferred; CCM credential preferred.

Responsibilities

• Coordinate care plans with physicians and APPs.
• Develop and implement individualized patient education plans.
• Monitor care plans and adjust based on outcomes and costs.
• Maintain accurate records and participate in IDT and huddles.
• Engage social determinants of health to support patient needs.

Skills

Patient care coordination

Virtual patient engagement

Interdisciplinary collaboration

Communication skills

Education

BSN preferred

CCM credential preferred

Tools

Microsoft Office

PowerPoint

EHR systems

Job description

Who You Are

You’re a collaborative professional, driven by the potential to make a meaningful impact in healthcare. The challenges of healthcare don’t deter you—instead, you see them as opportunities to find innovative solutions that benefit the partners, people, and communities we serve. Honest Health’s commitment to purpose, innovation, communities, and kindness resonates with you, inspiring you to bring commitment, creativity, and compassion into your work. You’re ready to join a team focused on reimagining primary care for a healthier future that benefits all. Does this sound like you?

Who We Are

At Honest Health, we believe in purpose and partnership to lead the transformation in primary care. Our team of healthcare experts and clinicians collaborates with a range of stakeholders—from health systems, physician organizations, and payers to providers, practices, and patients — to deliver innovative solutions that elevate care, control costs, and support long-term health. Guided by our core values, we’re creating a value-driven model that creates lasting benefits for everyone, now and into the future. For us, that’s just an Honest day’s work.

Your Role

You will manage patients’ specialized needs based on their individual condition(s) and/or reason for recent utilization in collaboration with physicians, advanced practice providers, and care coordination team members. Your job duties will include taking full ownership of assigned patients with complex chronic conditions, serious illness, advanced frailty, or recent healthcare utilization with the goal of avoiding preventable admissions, reducing unnecessary healthcare use, and optimizing patient outcomes. Through standardized assessments and workflows you will work with the patient to identify needs based on their values, goals and preferences. From this assessment, and in partnership with the patient and provider, you will develop an effective, and comprehensive nursing care plan for each member. These care plans will be used to coordinate patient care delivery with Honest clinicians, network providers, contracted vendors, and community-based services. This work takes place remotely, but you must be licensed in the state(s) where the role is based: New York and/or Michigan.

Primary Functions of the Nurse Care Manager Include

• Quickly build empathetic relationships with patients and families.
• Evaluate and identify patients’ needs based on their respective values, goals, and preferences, then translate these needs into clinical needs.
• Interface with primary care physicians, advanced practice providers (APP), specialists, and various disciplines on the development of case management plans/programs.
• In conjunction with the physician/APP, implement care/treatment plans by coordinating access to health services across multiple providers/ disciplines.
• Refer patients to internal Honest team members for care management activities as outlined by defined procedures.
• Monitor care and identify cost-effective measures, including recommendations for alternative levels of care and utilization of resources.
• In partnership with Honest team members, effectively coordinate patient admissions and discharges from hospitals or skilled nursing facilities via coordination with respective facility clinicians and case managers.
• Build relationships across network hospitals, SNFs, home health companies, and DME vendors within the respective community.
• Monitor and evaluate the effectiveness of the nurse care plans based on quality and cost drivers and modify as necessary.
• Coordinate the interdisciplinary approach to providing continuity of care, including transfer coordination, discharge planning and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.
• Act as a patient advocate and educator to assure that the patient has the knowledge to care for his/her condition and patient is educated and empowered to be responsible for participating in the plan of care.
• Develop individualized patient/family education plan focused on self-management and deliver patient/family education specific to a disease state.
• Engage internal resources to identify and respond to social determinants of health such as lack of transportation, stable housing, or food resources.
• Participate in data collection and analysis of clinical outcomes of care and customer satisfaction standards.
• Participate in the formulation and implementation and monitoring of action strategies and outcomes of care or customer service.
• Ensure that accurate records are maintained of the care associated with each patient.
• Actively participate in huddles, interdisciplinary team (IDT) sessions, and patient case conferences.
• Commendably represents Honest to patients, their families, and the community.
• Perform other related responsibilities as assigned.

Requirements

• Must have reliable access to high-speed internet to ensure seamless remote work communication and productivity.
• Active Registered Nurse license is required in the state(s) where the role is based: Michigan and/or New York.
• Willing and able to obtain additional state nursing license(s) as business needs dictate, with support from Honest leadership and reimbursement for required fees.
• Experience and high level of comfort with engaging patients virtually using different technologies including phone, text, video, etc. is required.
• Bachelor’s of Science in Nursing preferred.
• Certified Case Manager (CCM) credential preferred.
• 3+ years of clinical practice in a hospital, clinic, home care, or nursing home setting highly preferred.
• Case management experience with a senior population preferred.
• Disease management and/or physician office experience highly preferred.
• Prior experience with electronic health records or health registries required.
• Microsoft Office skills, including Excel, Word, PowerPoint, Outlook required.
• Experience with PowerPoint preferred.

The base pay range for this role is $76,600.00 - $88,900.00. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, and organizational needs. Base pay is just one piece of the total rewards program offered by Honest. Eligible roles also qualify for short-term incentives and a comprehensive benefits package.

Honest Health is committed to ensuring fairness, opportunity, strong teams, and full integration of team members into the organization. We take proactive steps to ensure all applicants are considered for employment based on merit, without regard to race, color, religion, sex, national origin, disability, Veteran status, or other legally-protected characteristics. Honest Health is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email [e-mail] for assistance. Reasonable accommodation will be determined on a case-by-case basis.

Honest Health values a secure and transparent recruitment process. We contact candidates through our official recruiting platform, email, or text message. When working directly with candidates, Honest Health will always use an HonestHealth.com email address. Our hiring process includes a live phone call or in-person interview before any formal offer is extended. To safeguard your personal information, Honest Health will never ask for confidential details—such as social security numbers, bank accounts, or routing numbers—before making a formal offer. We will also never request financial transactions, PINs, passwords, or security access details through email, text, Venmo, or any social media platform. We encourage all candidates to verify the contact information of individuals they interact with during the recruitment process. If you have any questions about the authenticity of a communication, please reach out to our team at [e-mail].