Registered Nurse Care Coach
C
CircleLink HealthHealthcare
United States. North Carolina, United States. Georgia, United States. Maryland, United States. Indiana, United StatesContractMiddle
Salary not disclosed
Apply NowOpens the employer's application page
Job Details
- Languages
- English, Spanish
- Experience
- 3+ years' experience
Requirements
- Fluent in English
- Self-directed, able to work independently with little supervision while meeting performance metrics
- Passion for nursing and improving patient outcomes
- Good with technology and eager to learn and use new software
- Excellent organizational and time management skills
- Timely communication is essential, and nurses are expected to respond to all messages and emails within 24–48 hours
- Strong critical thinking and problem-solving skills
- Current, unrestricted Compact License / multistate RN license
- Proficiency with electronic health records and web-based applications
- 3+ years' experience as a Registered Nurse
- RN needs a STRONG internet-connected computer
- Minimum of 20 hours of availability per week required
- Spanish fluency (preferred)
- Case Management or Chronic Disease Management experience highly preferred
- Certified Diabetes Educator (preferred)
- Experience with Motivational Interviewing or other behavior change communication techniques (preferred)
- Excellent documentation skills
- Strong time management
- Ownership of outcomes
Responsibilities
- Utilize our specialized care management software to call Medicare patients with 2 or more chronic conditions (Diabetes, CHF, Chronic Pain, COPD, etc.) on a monthly basis
- Build and maintain rapport with patients to help coach them to improved health through SMART goals and education on self-management strategies
- Implement and improve the Plan of Care by updating medications, appointments due, biometrics, symptoms, and interventions made
- Connect the patient with community resources as needed, including transportation, personal care needs, prescription/DME assistance, social services, etc.
- Conduct Transitional Care Management activities to high risk patients discharged from the hospital and the ER to reduce unnecessary readmissions.
- Close care gaps by encouraging and assisting with preventive care measures, i.e. annual well visits, vaccines, cancer screens, follow-up/specialist appointments, etc.
View Full Description & ApplyYou'll be redirected to the employer's site
