RN Care Navigator: Patient Care & Transitions

Colonial Group; Chicago (IL); Hybrid; USD 65,000 - 95,000; Full time

Job summary

Colonial Group seeks an experienced RN Care Coordinator to guide patients through transitions, provide disease education, and empower self-management. You will coordinate care for patients with complex conditions with a Triple Aim focus on experience, health, and cost.

Collaborating with an interdisciplinary team, you will conduct home visits when appropriate, document in EMR, and support quality initiatives and health equity efforts within the organization.

Qualifications

• RN with current Illinois licensure.
• Associate's degree required; bachelor's preferred.
• 1+ year health care experience preferred.
• Bilingual Spanish is a plus.

Responsibilities

• Lead intake and care plan development with program services.
• Manage patient panel, educate, and track patients by disease and self-management status.
• Lead patient-centered care planning using the nursing process.
• Conduct home/community visits as allowed by policy.
• Provide resources to support patient self-management and learning outcomes.
• Collaborate with interdisciplinary teams to optimize resource use and patient care.
• Assist transitions from outpatient to inpatient settings and arrange follow-up.
• Document all care interactions in the EMR for quality reporting.
• Support health equity initiatives and quality improvement projects.

Skills

Care coordination

Health education

Patient communication

Spanish language

Microsoft Office

Education

Associate's degree

Bachelor's degree

Tools

Electronic Medical Record (EMR)

Job description

Colonial Group seeks an experienced RN Care Coordinator to guide patients through transitions, provide disease education, and empower self-management. You will coordinate care for patients with complex conditions with a Triple Aim focus on experience, health, and cost.

Collaborating with an interdisciplinary team, you will conduct home visits when appropriate, document in EMR, and support quality initiatives and health equity efforts within the organization.