Market Clinical Nurse Manager/Case Manager (RN)

Market Clinical Nurse Manager/Case Manager (RN) About Sage Health We believe all seniors regardless of means deserve concierge primary care & wellness, without the concierge fees. They’ve earned it. Sage Health builds enriching neighborhood health centers that are easy to access, provide or arrange for all of our patients’ healthcare needs, and partner with Medicare Advantage plans that fully cover primary care. Unlike other physician practices, a Sage Health physician has a patient panel of 400 or less, and we collaborate with the best outcomes-oriented specialists and hospitals in each market. Because we are not a fee-for-service provider and manage patients within a global capitation budget provided by Medicare Advantage plans, our only concern and motivation is to keep our seniors healthy. Sage Health is a destination for the best risk provider talent in the country who are building the new standard-bearing senior model for the United States. Company Perks Join a growing company with a community focused mission to make a difference in the lives of seniors! Our employee Net Promoter Score (eNPS) ranks above industry standards reflecting our strong commitment to delivering exceptional service and satisfaction. We promote a company culture that values, recognizes, and rewards its employees for their contributions through Nectar, our employee engagement platform. Medical, Dental and Vision benefits with generous employer provided contributions to offset per paycheck premium costs. 3 different medical plan options to provide flexibility to meet personal needs including: 2 PPO options and a CDHP plan that includes a $500/year HSA employer match Healthcare & Dependent Care Flexible Savings Accounts (FSAs) Access to Employee Assistance Program (EAP) forsupport and work-life benefits for you and your immediate family. Employer-paid Life Insurance, Short-term and Long-term Disability benefits. Optional voluntary life insurance is also available. A 401k retirement plan offered through Transamerica for long-term financial savings & planning. Flexible time off including: generous PTO, 7 paid company holidays and 2 floating holidays. Opportunities for career growth and advancement within the company. All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a team of hardworking professionals dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring an accommodation to complete the application and/or interview process should contact View email address on click.appcast.io. About the role POSITION SUMMARY The Market Clinical Nurse Manager/Case Manager (RN) is responsible for delivering comprehensive clinical leadership and case management support across the market, ensuring high-quality, patient-centered care for a diverse geriatric population. The role consists of approximately 40% Case Management responsibilities and 60% Clinical Nurse Manager responsibilities , including hands‑on clinical support, market‑level operational oversight, and leadership responsibilities as the role expands. This role is responsible for implementing and reviewing individualized healthcare plans for patients recovering from serious illnesses or managing chronic conditions, while also providing operational clinical oversight and support to ensure efficient market‑wide clinical operations. This position collaborates closely with physicians, clinical staff, operational leadership, patients, families, hospitals, insurance providers, and interdisciplinary care teams to coordinate care, advocate for patient needs, improve health outcomes, and ensure continuity of care. The Market Clinical Nurse Manager/Case Manager (RN) demonstrates competency and skill in serving medically underserved and culturally diverse geriatric populations while ensuring compliance with all nursing standards, regulatory requirements, and organizational policies. What you'll do Clinical Leadership & Operational Oversight Provides leadership and management for assigned staff, including but not limited to interviewing, hiring, onboarding. training, developing, coaching, mentoring, and discipling, as needed. Effectively mentors and coaches clinical staff collaboration with providers, operations and clinical leadership. Acts as the primary clinical resource for MAs in the market, providing training, guidance, and education, as needed. Maintain a safe, secure, and healthy work environment by following Sage Health policies and procedures and complying with legal and regulatory requirements. Provide Medical Assistant (MA) coverage as needed to support clinic operations during staffing shortages or high patient census. Monitor provider inboxes, ensuring timely review and follow‑up. Manage medication refill requests across the market. Handle phone triage and patient clinical concerns across the market. Collaborate with physicians, clinical support staff, and operations leadership to optimize workflows and patient outcomes. Hold regular meetings and communication cadences with clinical support staff, physicians, and operational leadership. Support daily clinical operations and assist with workflow management across centers. Maintain readiness for health plan audits and local, state, and federal inspections. Stay current on nursing regulations, standards of practice, and compliance requirements. Support role expansion by assuming additional clinical and operational responsibilities as Patient Care Management & Coordination Ensure patient information always remains secure and confidential. Create, implement, and manage individualized care plans for patients with chronic or serious medical conditions, including diabetes, heart disease, chronic heart failure, cancer, and other complex illnesses. Advocate for personalized treatment options that address each patient’s unique care needs. Coordinate patient care across healthcare settings to ensure continuity and quality outcomes. Schedule post-hospital discharge follow‑up appointments within 72 hours (3 days) and ensure patient attendance. Verify daily patient hospital census reports and planned discharges. Communicate effectively with patients and families regarding health conditions, treatment plans, and care transitions. Collaborate with primary care physicians to educate patients and families in navigating complex medical decisions. Serve as a liaison between patients and insurance providers to promote cost‑effective, quality care with optimal outcomes. Identify and provide appropriate educational resources and support services to patients and families in collaboration with the Chief Medical Officer or designee. Assist primary care physicians in executing virtual appointments in patients’ homes. Ensure patients’ electronic health records are updated accurately with current medical treatments and clinical documentation. Ensure overall quality of healthcare delivery for each patient. Compliance & Quality Assurance Ensure compliance with all applicable state, federal, OSHA, CLIA, and healthcare regulatory requirements. Maintain documentation standards and audit readiness across all clinical operations. Monitor adherence to organizational clinical policies and procedures. Promote continuous quality improvement initiatives to enhance patient outcomes and operational effectiveness. Qualifications Required Qualifications Bachelor of Science in Nursing (BSN) Valid and active Registered Nurse (RN) license in the state of employment Current Basic Life Support (BLS) certification 5+ years of experience in healthcare management. Must have solid people management skills related to hiring, onboarding, training, coaching, developing, and disciplining staff. 2–3 years of experience in inpatient, outpatient, home health, hospice, or health plan case management settings Strong clinical assessment skills and chronic disease management experience Experience working in medically underserved and culturally diverse communities Excellent interpersonal, written, and verbal communication skills Strong organizational skills with exceptional attention to detail Ability to manage competing priorities in a fast‑paced environment Resourceful problem‑solving abilities Demonstrated accountability and ability to follow through on assigned responsibilities Experience working with electronic health records (EHR) Skilled in web navigation and use of mobile hotspot technology Valid driver’s license, automobile insurance, and reliable transportation Ability to travel between healthcare facilities including centers, hospitals, skilled nursing facilities, and patient homes Preferred Qualifications Certification in Case Management (ACM or CCM) Managed care experience, including Medicare HMO and D-SNP Knowledge of value‑based care models Motivational interviewing experience Bilingual in Spanish and English Reports To Operations & Network Director Physical Requirements Primary Duty: YES (75‑100%) Hearing: YES (75‑100%) Standing: YES (75‑100%) Walking: YES (75‑100%) Lifting/Pulling/Pushing: YES (75‑100%) Sage Health will adhere to all federal, state, and local regulations, as well as all client requirements, and will obtain necessary proof of vaccination. Boosters, when applicable, before employment to ensure compliance. #J-18808-Ljbffr