Offer summary
Qualifications:
Current, unrestricted Compact License, 3+ years experience as a Registered Nurse, Fluent in English, Proficiency with electronic health records.
Key responsabilities:
- Conduct monthly calls with patients enrolled in Chronic Care Management Program
- Provide education, coordinate care and close preventive care gaps
- Connect patients to community resources as needed
- Implement and improve Plans of Care for managing chronic conditions
- Reduce readmissions through Transitional Care Management