RN Care Coordinator: Chronic Care & Transitions

Cleveland Clinic; Cleveland (OH); Hybrid; USD 63,000 - 96,000; Full time

Job summary

Cleveland Clinic is seeking a Care Coordinator on the Main Campus to collaborate with multidisciplinary teams for high‑risk patients. You will coordinate care across the continuum, focusing on outreach and disease management to improve outcomes and reduce preventable readmissions.

The role follows an 8:00am–4:30pm schedule with no weekends or on-call requirements, plus one work-from-home day after orientation. RN licensure, BLS, and 3–5 years of nursing experience are required.

Qualifications

• Graduate from an accredited school of Professional Nursing.
• Current state licensure as a Registered Nurse (RN).
• BLS Certification through AHA or Red Cross.
• Three to five years of nursing experience.
• Cancer-specific certification or ongoing qualifying education within accreditation cycle if working in oncology.

Responsibilities

• Coordinate care and disease management for high-risk patients.
• Provide care coordination for chronic conditions or surgical patients.
• Perform comprehensive clinical assessments including disease, age, medical, behavioral, social needs.
• Educate and coach patients and families on care plans and monitor progress.
• Act as liaison and advocate for patients and families.
• Assist transitions of care across settings to ensure effective planning and communication.
• Identify barriers and connect to community resources.

Skills

Care coordination

Patient education

Team collaboration

Clinical assessment

Education

RN licensure

BLS Certification

BSN (preferred)

Tools

EMR system

Job description

Cleveland Clinic is seeking a Care Coordinator on the Main Campus to collaborate with multidisciplinary teams for high‑risk patients. You will coordinate care across the continuum, focusing on outreach and disease management to improve outcomes and reduce preventable readmissions.

The role follows an 8:00am–4:30pm schedule with no weekends or on-call requirements, plus one work-from-home day after orientation. RN licensure, BLS, and 3–5 years of nursing experience are required.