Registered Nurse, Care Manager - Enhanced Care Management

Neighborhood Healthcare•Temecula, CA

1d•$46 - $68•Hybrid

About The Position

The Registered Nurse Care Manager supports Enhanced Care Management (ECM) patients with complex medical conditions and completes medication reconciliation with pharmacies for all ECM-enrolled patients. The role provides care coordination and connects patients with services and social support, including appointment scheduling and referral management. It requires travel to Neighborhood Healthcare sites for designated meetings and trainings. The position is hybrid, with on-site expectations dependent on performance. The RN Care Manager manages a patient caseload, supports patients in pursuing health goals, tracks medical and behavioral health outcomes, provides health education, coordinates with providers and hospitals, conducts medication reconciliations, and ensures required assessments and screenings are completed. The role also documents services in ECW, contributes to quality improvement activities, and provides reports to management as needed. Pediatric RN Care Manager duties include helping individuals and families access basic needs such as medical care, food, behavioral health services, and safety, as well as providing one-on-one counseling to high-risk pediatric and adult patients. The organization is a private, nonprofit 501(c)(3) community health organization serving more than 100,000 people annually. It has operated since 1969 and focuses on providing quality care to all, regardless of situation or circumstance.

Requirements

Associate degree in nursing required.
California Registered Nurse license required.
Current Basic Life Support (BLS) certification from an American Heart Association-approved source required upon hire and must be maintained; the course must include an in-person, hands-on skills check with a certified instructor.
Valid California driver’s license, or an out-of-state driver’s license for active military personnel or spouses, required.
Proof of auto insurance required.
Three years of experience in nursing or case management required.
Experience with community outreach, behavioral health, and working with high-risk and/or pediatric populations required.
Excellent verbal and written communication skills, including composition, typing, and proofreading.
Ability to work with Microsoft applications such as Excel and Word.
Ability to interpret written, oral, diagram, or schedule-based instructions.
Ability to interact effectively with clinic personnel, patients, and community-based organizations.
Knowledge of and experience with social and health issues.
Knowledge of and experience with evidence-based communication such as Motivational Interviewing or similar empathy-based strategies.
Excellent interpersonal and conflict-resolution skills.
Ability to engage patients and providers by phone and in person.
Sensitivity to multicultural communities, mental health conditions, and addictive disorders.
Awareness of the impact of unmitigated bias and judgment on health, and commitment to addressing both.
Ability to manage multiple tasks simultaneously and strong planning and organizational ability.
Ability to work independently and as part of a team.
Ability to handle highly confidential information professionally and ethically.
Ability to lift or carry 25 pounds and stand for long periods.

Nice To Haves

Bachelor’s degree in nursing preferred.
Two years of clinical, outpatient, or general medicine experience preferred.
Bilingual in English and Spanish preferred.

Responsibilities

Manage a caseload of patients with complex medical needs.
Engage, support, and encourage patient activation toward achieving health goals.
Track medical and behavioral health outcomes in web-based care management and patient electronic health information platforms.
Provide chronic medical and behavioral health education to patients and families to improve health literacy.
Prioritize patient cases for systematic population and caseload review, gathering input from ECM team members.
Facilitate communication between patients and providers by identifying health and wellness goals for health action and shared care plans.
Coordinate physical care management and care coordination relationships with external healthcare providers.
Receive, identify, and follow up on treatment and medication alerts.
Consult with ECM team members about clinical concerns and questions.
Coordinate patient admissions and discharges with hospitals to support smooth transitions of care.
Conduct medication reconciliations with input from providers and pharmacies.
Track and ensure completion of required assessments and screenings, including comprehensive health assessments and shared care plans.
Review adult comprehensive health assessments completed by other care team members.
Participate in quality improvement activities.
Document patient care coordination, education, and other services in ECW.
Prioritize activities according to intensity, need, and required follow-up.
Provide accurate and timely reports to management as needed.
For pediatric RN Care Manager duties, help individuals and families access basic needs, including medical care, food, behavioral health services, and safety.
For pediatric RN Care Manager duties, conduct one-on-one counseling with high-risk pediatric and adult patients.
Travel to Neighborhood Healthcare sites for designated meetings and trainings.
Follow safety, infection control, privacy, corporate integrity, and security requirements; report unsafe, unethical, fraudulent, or unlawful behavior or activity.