Clinical Care Nurse - Florida
$71,100–$97,800 year
On-siteAventura, Florida, United States or North Miami Beach, Florida, United States
Job Summary
Analyze clinical data from Athena EMR and DataHub to identify gaps in care related to Medicare Advantage Stars and HEDIS measures. Proactively identify recently discharged inpatient, observation, and emergency department patients to coordinate post-discharge follow-up and prevent avoidable readmissions. Conduct targeted patient and provider outreach via phone, telehealth, and in-clinic visits to provide education on chronic disease management and medication reconciliation. Collaborate with interdisciplinary teams to implement evidence-based interventions and optimize workflows while documenting all interactions in compliance with CMS standards. Participate in center huddles and quality improvement projects to monitor progress toward Stars goals and develop innovative solutions.
Required Qualifications
- Associate's degree in nursing (ADN) -OR- Bachelor's degree in nursing (BSN)
- Active, unrestricted RN license in the State of Florida
- 3+ years' clinical nursing experience with exposure to transitions of care, quality improvement, managed care, or population health management
- Proficiency with electronic health records (e.g., Athena EMR), data analytics tools (e.g., DataHub, Compass Rose, SalesForce HealthCloud – per your prior employer's population health tools), and Microsoft Office Suite
- Willing and able to complete and maintain Basic Life Support training
- Must meet one of the following requirements: Associate's degree in nursing (ADN) -OR- Bachelor's degree in nursing (BSN)
- Active, unrestricted RN license in the State of Florida
- 3+ years' clinical nursing experience with exposure to transitions of care, quality improvement, managed care, or population health management
- Proficiency with electronic health records (e.g., Athena EMR), data analytics tools (e.g., DataHub, Compass Rose, SalesForce HealthCloud – per your prior employer's population health tools), and Microsoft Office Suite
- Willing and able to complete and maintain Basic Life Support training
- Valid state driver's license
- Must reside in designated market area, in reasonable commutable distance to assigned clinic(s)
- Monday–Friday, 8:00 AM–5:00 PM
- In-center presence, involving daily commute to assigned clinic(s)
- Occasional (quarterly) travel within the market to alternative clinic(s) for strategic meetings
- Clinic-based, in-center 5 days per week
- Must be screened for TB
Desired Qualifications
- Knowledge of Medicare Advantage Stars, HEDIS, CAHPS, and CMS quality requirements
- Experience with Transitions of Care, hospital discharge or ER follow up programs
- Strong clinical judgment, data analysis skills, and ability to apply evidence-based practices
- Excellent communication and motivational interviewing skills to educate and empower members
- Commitment to health equity, inclusiveness, and patient-centered care
- Bilingual in English and Spanish with full professional proficiency (strongly preferred)
- Basic Life Support trained
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