RN Care Manager

Jobtailor

Four Oaks (NC)

On-site

USD 65,000 - 90,000

Full time

3 days ago
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Job summary

Jobtailor is seeking a Registered Nurse to join our care management team in North Carolina. The role focuses on identifying patients for care management, assigning acuity levels, and guiding care team assignments to develop individualized plans.

Responsibilities include coordinating with PCPs and the care team, managing transitions of care, medication reconciliation, education, and collaboration with community partners to improve outcomes for patients with multiple chronic conditions.

Qualifications

  • Graduate of an accredited RN program.
  • North Carolina RN license is required.
  • 2+ years of experience in primary healthcare, ambulatory care and/or home health within the last 5 years.
  • High school diploma or GED.
  • Comfortable navigating an electronic health record (EHR).
  • Valid North Carolina driver's license and clean driving record, approved for driving privileges.
  • Experience with underserved or rural populations preferred.
  • Spanish speaking preferred, not required.

Responsibilities

  • Identify patients who meet criteria for the care management program.
  • Review charts to assign acuity levels and assign patients to the appropriate care team.
  • Provide oversight to Care Coordinators completing comprehensive assessments and developing individualized care plans.
  • Develop and update care plans in collaboration with patients, PCPs, and the care team.
  • Support transitions of care, including medication reconciliation, follow-up, specialist referrals, barriers to care, and education.
  • Coordinate communication with community partners such as hospitals, emergency departments, and discharge planners.
  • Support PCMH implementation and help teams understand care coordination workflows.
  • Monitor outcomes, identify gaps, and recommend improvements.
  • Coordinate care for patients with multiple chronic conditions as part of a multidisciplinary population-management team

Skills

Care coordination
EHR navigation
Patient care management
Spanish speaking
Chronic condition management
Care plan development

Education

RN licensure (North Carolina)
High school diploma or GED

Tools

EHR systems

Job description

  • Identify patients who meet criteria for the care management program
  • Review charts to assign acuity levels and assign patients to the appropriate care team
  • Provide oversight to Care Coordinators completing comprehensive assessments and developing individualized care plans
  • Develop and update care plans in collaboration with patients, PCPs, and the care team
  • Support transitions of care, including medication reconciliation, follow-up, specialist referrals, barriers to care, and education
  • Coordinate communication with community partners such as hospitals, emergency departments, and discharge planners
  • Support PCMH implementation and help teams understand care coordination workflows
  • Monitor outcomes, identify gaps, and recommend improvements
  • Coordinate care for patients with multiple chronic conditions as part of a multidisciplinary population-management team
Requirements
  • Graduate of an accredited RN program
  • Current North Carolina RN License
  • 2+ years of experience in primary healthcare, ambulatory care and/or home health within the last 5 years
  • High school diploma or GED
  • Comfortable navigating an electronic health record (EHR)
  • Valid North Carolina driver's license and clean driving record, approved for driving privileges
  • Experience with underserved or rural populations preferred
  • Spanish speaking preferred, not required
  • Compassionate, organized, and clinically strong
  • Passion for coordinating care for patients living with multiple chronic conditions
Core Competencies

Demonstrates expertise in care coordination for patients with multiple chronic conditions, including developing and updating individualized care plans, conducting comprehensive assessments, and collaborating with multidisciplinary teams. Proficient in navigating electronic health records and supporting transitions of care while ensuring effective communication with community partners.

Highest-signal resume keywords
  • Registered Nurse (RN)
  • Care Coordination
  • Electronic Health Record (EHR) Navigation
  • Patient Care Management
  • Spanish Speaking
Hard Skills
  • Comprehensive Assessments
  • Individualized Care Plans
  • Medication Reconciliation
  • Chronic Condition Management
  • Acuity Level Assignment
Soft Skills
  • Compassionate
  • Organized
  • Clinically Strong
Certifications & Qualifications
  • North Carolina RN License
Industry Keywords
  • Primary Healthcare
  • Ambulatory Care
  • Home Health
  • PCMH Implementation
  • Underserved Populations
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