RN Care Manager: Chronic Disease & Behavioral Health Advocate

Cityblock Health; Charlotte (NC); On-site; USD 90,000 - 95,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Retirement benefits

Equity program

Paid time off

Job summary

Cityblock Health is seeking an RN Case Manager in Charlotte, NC to oversee a panel of members with chronic conditions and behavioral health needs. You will develop and monitor individualized care plans, coordinate with the care team and providers, and advocate for patients through community resources.

You will perform clinical visits, acute and routine assessments, and ensure documentation and coding accuracy while managing medications and safety. Travel within the community is expected.

Qualifications

• Active, unrestricted RN license in the state where employed.

Responsibilities

• Receive members from the engagement and care team, communicating program expectations, duration and goals.
• Complete self-efficacy and condition-specific screeners during assessment and intake, including PHQ-9, GAD-7, AUDIT, DAST-10.
• Conduct in-person clinical examinations and collaborate with care team to assign member placement in programs of varying intensity.
• Prepare for and participate in case conferences, leading discussions when necessary.
• Develop care plans with the member and address social needs with the Community Health Partner.
• Conduct regular clinical visits and follow-ups per program guidelines, monitor therapeutic interventions and address needs promptly.
• Collaborate to support a panel of members, providing clinical assistance in health maintenance and chronic disease management.
• Perform medication reconciliation, administration, compliance, and education.
• Address quality gaps and ensure thorough chart documentation and coding (ICD/CPT).
• Utilize EHRs and scheduling platforms to gather data, document interactions, organize information and communicate with resources.
• Support members in achieving their care plan goals through coordinated care efforts.

Skills

Clinical care coordination

Documentation

Interdisciplinary teamwork

Wound assessment

Phlebotomy

Travel to home-based visits

Excellent writing skills

Education

Graduate of an accredited school of nursing (R.N.)

Job description

Cityblock Health is seeking an RN Case Manager in Charlotte, NC to oversee a panel of members with chronic conditions and behavioral health needs. You will develop and monitor individualized care plans, coordinate with the care team and providers, and advocate for patients through community resources.

You will perform clinical visits, acute and routine assessments, and ensure documentation and coding accuracy while managing medications and safety. Travel within the community is expected.