Clinical Care Nurse (RN)
$71,100–$97,800 year
On-siteMyrtle Beach, South Carolina, United States or Murrells Inlet, South Carolina, United States
Job Summary
Analyze clinical data from Athena EMR and DataHub to identify care gaps related to Medicare Advantage Stars and HEDIS measures. Proactively identify recently discharged inpatient, observation, and emergency department patients to coordinate timely post-discharge follow-up and prevent avoidable readmissions. Conduct targeted patient and provider outreach via phone, telehealth, and in-clinic visits to close care opportunities and provide education on chronic disease management. Collaborate with interdisciplinary teams to implement evidence-based interventions, monitor progress toward quality goals, and document all interactions in compliance with CMS standards. This clinic-based role supports safe Transitions of Care and drives quality performance across the South Carolina market.
Required Qualifications
- Associate's degree in nursing (ADN) -OR- Bachelor's degree in nursing (BSN)
- Active, unrestricted RN license (state specific as applicable)
- 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
- Active, unrestricted RN license in state of South Carolina
- Valid state driver's license
- Personal vehicle liability insurance
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
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.