Nurse Care Manager
On-siteTucson, Arizona, United States
Job Summary
Oversee chronic care and transitions of care for high-risk patients within neighborhood centers, managing complex cases and populations through multidisciplinary collaboration. Perform comprehensive assessments for physical, mental, and social risk factors while coordinating timely, cost-effective patient transitions from acute to post-acute settings. Facilitate care progression throughout the continuum by completing diagnostic testing, treatment plans, and discharge plans, ensuring all critical elements are communicated to patients and families. Proactively identify at-risk populations, resolve issues impeding progress, and schedule follow-ups within seven days of discharge to reduce readmissions. Utilize data to drive performance improvement strategies, document all interactions in the Electronic Medical Record, and refer cases for social work or external case management as needed. Available to work full-time during assigned clinic business hours.
Required Qualifications
- Minimum 2 years of experience as a Registered Nurse
- Minimum 2 years of experience in utilization management, case management, chronic care management, discharge planning, transitions of care management, cost/quality management program, and/or other related field
- Available to work during assigned clinic business hours
- Current working knowledge of chronic care management, discharge planning, utilization management, case management, performance improvement and/or managed care reimbursement
- Competency in chronic care management, pre-acute, and post-acute venues of care, and post-acute community resources
- Excellent interpersonal communication, leadership, collaboration, and negotiation skills
- Effective oral and written communication skills
- Strong technical skills including data analysis and management, competency in Microsoft Office suite, and Electronic Medical Records
- Strong organizational and time management skills
- Ability to work independently and exercise sound judgment in interactions with providers, payors, patients, and their families
- Active Multi-state Compact Registered Nurse License
Desired Qualifications
- Experience with Medicare Advantage, Value-based care, and/or Managed Care desirable
- Bilingual/Bicultural (English and Spanish) Preferred
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