Nurse Care Manager

Care Management Nurse (NY License Required) - RemoteMobile Primary Care is a home-based primary care practice that specializes in geriatric healthcare, serving New York State.A healthcare organization seeking a licensed LVN, LPN or RN to join their growing staff as a new Care Management Nurse. This role will be providing telephonic Care Management for patients throughout the health system under the direction of a patient's provider.The nurse utilizes nursing process to evaluate patient needs over the telephone and provide guidance and education to patients, adhering to organizational policies, procedures and guidelines. Provides high risk patients with chronic disease management and liaises between the patient, patient's family or caregiver, provider, provider's office, hospital, home care agency etc. This position is telephonic care coordination as directed by the patients provider.Position Responsibilities:Cooperatively develop and integrate patient centered provider care plan and goals with the client/family and other providersWork collaboratively with team members to provide outreach and engagement with the patientWork closely with in-office providers/staff members to:Provide patient education to assist with self-managementIdentify gaps or barriers in treatment plansCoordinate care enrolled patients including scheduling appointmentsCoordinate referralsCoordinate community resources as needed (ie: home health, DME etc)Educate members on disease processesEncourage members to make healthy lifestyle changesActively maintain assigned caseload of patientsMake outbound calls to assess members current health statusReceive and respond to telephone calls from patients. Collecting health data and providing medical guidance under the direction of the patients providerDocument calls according to established guidelinesConnects patient's care team together with updated information as receivedParticipation in education and in-service programsPerforms on-call for region that you are assignedAdditional duties as assignedRequired Qualifications:Unrestricted and current license to practice as LVN/LPN/RN with a New York State license.3 years of experience within Care Management setting or Case Coordinator either in the homecare, inpatient, physician practice or in-home case management settingStrong working knowledge of chronic disease states including chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease and congestive heart failure and basic medical management of these statesMust be highly motivated, result-oriented with strong skills in presenting, communicating, organizing and time management skillsStrong organizational and interpersonal skillsExcellent customer service skills demonstrated by positive feedback from patients/teamAbility to identify problems and recommend solutionsDemonstrates progressive proficiency with the utilization of available computer technology, including typing skillsDemonstrates; leadership, communication, interpersonal and problem-solving skillsExperience working with Electronic Health Record (EHR)Ability to sit and work at a computer for extended periods of time60 words per minute typingPreferred Qualifications:Bilingual in Spanish