RN Care Manager- North Carolina- Hybrid

Cityblock Health•High Point, NC

2d•$90,000 - $95,000•Hybrid

About The Position

The RN Care Manager (RNCM) manages a panel of rising- and high-intensity members, supporting integrated chronic disease and behavioral health care. The RNCM collaborates with members to develop care plans and oversees progress by reassessing needs, coordinating with providers and specialized resources, and partnering with the Community Health Partner to build trust and advocate for members. The role includes receiving and orienting members to the program; completing clinical, self-efficacy, and behavioral health assessments; coordinating care across an interdisciplinary team; conducting clinical visits and follow-ups; supporting health maintenance and chronic disease management; and helping members achieve their care plan goals. The RNCM also performs medication-related care, addresses quality gaps, and maintains thorough clinical documentation and coding. This is a hybrid role in North Carolina that involves travel within the community for home-based member visits and visits to healthcare settings such as hospitals and rehabilitation centers. The expected salary range is $90,000–$95,000. The role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, and paid time off, including vacation and sick leave. Medical clearance is required for member-facing roles, subject to approved medical or religious accommodations.

Requirements

Active, unrestricted Registered Nurse license in the state of employment.
At least 3 years of experience providing clinical services to adults and/or geriatric individuals with co-occurring chronic medical and behavioral health conditions.
Familiarity and willingness to travel within the community for home-based member visits and to healthcare systems, including hospitals and rehabilitation centers.
Experience with documentation, care planning, and care coordination, along with excellent writing skills.
Experience and comfort working within an interdisciplinary care team, including alongside community health workers and care coordination team members.
Prior experience with, or willingness to train in, clinical nursing skills such as wound assessment and care, blood drawing (venipuncture and phlebotomy), and assessment and care plan reinforcement for common chronic conditions such as diabetes, hypertension, CHF, and depression.
Graduate of an accredited school of nursing (R.N.).
Completion of Cityblock’s medical clearance requirements for member-facing roles, including evidence of immunity to MMR, Hepatitis B, and Varicella, and a TB screen, unless an approved medical or religious accommodation applies.

Responsibilities

Receive members from the engagement and care team and communicate program expectations, including program duration and goals.
Complete self-efficacy and condition-specific screeners during assessment and intake, including behavioral health screeners such as PHQ-9, GAD-7, AUDIT, and DAST-10.
Conduct in-person clinical examinations when appropriate and collaborate with care team members to determine placement in programs of varying intensity.
Prepare for and participate actively in case conferences, leading discussions when necessary.
Develop care plans in collaboration with members and address social needs with support from the Community Health Partner.
Conduct regular clinical visits and follow-ups according to program guidelines, monitor routine therapeutic interventions, and address member needs promptly.
Collaborate with the care team to support assigned members with health maintenance, chronic disease management, and co-occurring psychiatric disorder support.
Perform medication reconciliation, administration, compliance support, and education as part of member care.
Address quality gaps prioritized by the contracted company and ensure thorough chart documentation and ICD or CPT coding to validate gap closures.
Use care facilitation tools, electronic health records, and scheduling platforms to gather data, document member interactions, organize information, track tasks, and communicate with team members and community resources.
Support members in achieving care plan goals through coordinated and comprehensive care efforts.