RN Care Coach for Chronic Condition Management

Optum

Dallas (TX)

On-site

USD 60,000 - 107,000

Full time

14 days+

Application generator

Turn this role into an interview — a resume and cover letter built around what this employer wants.

Get past ATS filters

Job summary

WellMed, part of the Optum family, is seeking a Registered Nurse to join our Dallas, TX team. The Healthcare Manager will support patients with high-risk conditions to navigate the healthcare system and work with multidisciplinary care teams.

This role involves assessment, medication reconciliation, motivational interviewing, patient education, and developing care plans. The position offers a comprehensive benefits package and opportunities for professional growth.

Qualifications

Bachelor's degree in Nursing or Associate's degree in Nursing with 4+ years of experience.
Registered Nurse with an active and unrestricted license to practice in the state of employment
Current BLS certification
2+ years of experience in a physician's office, clinical or hospital setting
Experience interacting productively with individuals and with multidisciplinary teams
Knowledge of chronic diseases, especially COPD / asthma, diabetes, CHF and IHD
Proficient computer skills to work efficiently with electronic medical records

Responsibilities

Works with the providers and clinic staff to identify patients at high risk
Supports longitudinal care of the patient with chronic care conditions by performing assessment of health conditions
Performs medication reconciliation
Conducting motivational interviewing and self-management goal setting
Providing patient education
Creating referrals to appropriate agencies and resources
Supports transition of the patient with chronic care conditions from inpatient to outpatient setting, by performing assessment of transitional needs
Performing medication reconciliation
Establishing and reviewing contingency plan
Providing patient education
Assisting with post discharge needs such as prescriptions, transmutation, Durable Medical Equipment (DME), appointments
Coordinate with providers to establish or update plan of care
Performs accurate and timely documentation in the electronic medical record
Participates in daily huddles and Patient Care Coordination (PCC) meetings
Prepares accurate and timely reports, as required, for weekly meetings
Maintains continued competence in nursing practice and knowledge of current evidence based practices
May perform clinical tasks within their scope of practice
Performs all other related duties as assigned