Job Overview

The Nurse, reporting to the Director of Clinical Operations or designee, is responsible for engaging high-risk members with event-driven care management using evidence-based guidelines. This includes assessing healthcare needs, creating action plans, managing care transitions, coordinating care for complex conditions, and promoting evidence-based healthcare. Working within an interdisciplinary team, the Nurse ensures high-quality outcomes for patients and families managing chronic diseases, always involving and gaining signoff from caregivers.

Primary Responsibilities

• Develop care pathway templates by condition and risk levels.

• Create action plans for members based on chronic condition alerts.

• Implement remote patient monitoring and self-reporting for high-risk conditions.

• Conduct in-home or telehealth assessments as needed.

• Respond in real-time to patient alerts, communicating with members and caregivers.

• Monitor remote patient tools and notify the team of any required follow-up.

• Coordinate patient care, including navigation, chronic disease management, and interdisciplinary collaboration.

• Conduct assessments with patients and caregivers to develop and track action plans.

• Engage patients in managing their health and refer them to community resources.

• Follow evidence-based guidelines to close care gaps and determine in-home service needs.

• Use electronic medical records or care management platforms for coordination activities.

• Participate in team rounds to support program development and process improvement.

• Reassess action plans post-discharge.

• Prioritize tasks to effectively manage patient care load.

• Collaborate daily with the interdisciplinary team for patient care planning.

General Duties

• Collaboration: Work closely with other divisions to meet business objectives.

• Knowledge: Provide expertise in clinical solutions and event-based care management.

• Culture : Create a productive, collaborative, safe, and inclusive work environment.

Qualifications

• Education: Active Illinois state RN license; BSN required.

• Experience: At least 5 years of clinical experience, with 3+ years in care management preferred.

• Skills: Excellent verbal and written communication, proficiency in Microsoft Office.

• Relationships: Ability to build and manage relationships with business leaders and external partners.

• Culture: Good judgment, ethics, and a strong team player; thrive in a fast-paced, entrepreneurial environment.

Location: California

Compensation: $125,000 annually

Work Arrangement: Hybrid; primarily work from home with potential visits to patient homes, hospitals, facilities, and main offices.

Benefits:

• Medical

• Dental

• Vision

• Life & Disability

• FSA

• Commuter

Pay Details: $125,000.00 per year

Equal Opportunity Employer/Veterans/Disabled

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The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.