RN Case Manager - Hybrid Senior Care Coordinator

TEEMA Group; San Jose (CA); Hybrid; USD 69,000 - 76,000; Full time

Benefits offered by this job

Hybrid clinic & field work

Job summary

TEEMA Group is seeking a compassionate RN Case Manager to support an elderly population with coordinated care and patient-centered outcomes. You will work with primary care providers and an interdisciplinary team to assess needs, create care plans, and advocate for patients.

The role involves clinic, virtual, and home visits, focusing on reducing hospitalizations and improving quality of life. A California RN license and BLS are required, with 2+ years of relevant experience.

Qualifications

• Active, unrestricted California RN license.
• Graduate of an accredited School of Nursing.
• Current Basic Life Support (BLS) certification.
• Minimum of 2 years of RN experience caring for frail or elderly adults.
• Strong clinical assessment and critical thinking skills.
• Excellent communication, organizational, and multitasking abilities.
• Ability to work independently while collaborating with an interdisciplinary healthcare team.
• Willingness to travel locally for home visits (2–5 times per week).

Responsibilities

• Manage an assigned panel of patients and own clinical outcomes and quality of care.
• Perform nursing assessments in clinic, virtually, and during home visits.
• Develop, implement, and update individualized Care Plans with providers, patients, families, and caregivers.
• Educate patients and families on chronic illness management, medications, disease prevention, and healthy living.
• Identify changes in patient condition and coordinate timely interventions with the healthcare team.
• Coordinate care across hospitals, EDs, SNFs, home health, hospice, and specialty providers.
• Facilitate smooth transitions of care to reduce hospitalizations and improve outcomes.
• Coordinate referrals for specialty care, labs, procedures, transportation, and community resources.
• Maintain accurate, timely, and compliant EHR documentation.

Skills

RN clinical assessment

Critical thinking

Communication

Organizational skills

Multitasking

Travel to home visits

Education

Nursing degree (RN)

Job description

TEEMA Group is seeking a compassionate RN Case Manager to support an elderly population with coordinated care and patient-centered outcomes. You will work with primary care providers and an interdisciplinary team to assess needs, create care plans, and advocate for patients.

The role involves clinic, virtual, and home visits, focusing on reducing hospitalizations and improving quality of life. A California RN license and BLS are required, with 2+ years of relevant experience.