RN Care Manager: High-Risk Care Coordination & Transitions

Jobtailor; Flint Hill (MO); On-site; USD 65,000 - 95,000; Full time

Job summary

Jobtailor is seeking a Registered Nurse to manage a caseload of high-risk patients in a community health setting. You will perform Transitional Care Management, Chronic Care Management, Disease Management Education, and Medication Education, developing and monitoring individualized care plans.

You will coordinate with the care team, educate patients and caregivers, review records for gaps, and serve as liaison across home, hospital, and post-acute settings to improve outcomes.

Qualifications

• Active RN license is required.
• 2+ years of care management experience in community, health plan or hospital systems.
• Strong clinical skills and proactive thinking are essential.
• Effective communication skills are necessary for patient and team interactions.
• Ability to perform extensive telephone assessments and coordinate care.

Responsibilities

• Manage a caseload of high-risk patients and their care barriers.
• Perform Transitional Care Management, Chronic Care Management, Disease Management Education, and Medication Education.
• Develop and manage patient care plans.
• Coordinate transitions of care and prevent avoidable hospital admissions.
• Review medical records to identify care gaps and coordinate services.

Skills

Active RN License

Care Management

Clinical Skills

Effective Communication

Telephone Assessment

Patient Care Coordination

Time Management

Teaching/Training

Education

Bachelor of Science in Nursing (BSN) or related field

Tools

Email

Word

Excel

PowerPoint

Job description

Jobtailor is seeking a Registered Nurse to manage a caseload of high-risk patients in a community health setting. You will perform Transitional Care Management, Chronic Care Management, Disease Management Education, and Medication Education, developing and monitoring individualized care plans.

You will coordinate with the care team, educate patients and caregivers, review records for gaps, and serve as liaison across home, hospital, and post-acute settings to improve outcomes.