Registered Nurse - Chronic Care Management (CCM RN) - Remote

Overview

We are seeking a dedicated and compassionate Chronic Care Management (CCM) Registered Nurse (RN) to provide care coordination, patient education, and ongoing support for individuals with chronic conditions. The CCM RN will work closely with patients, families, and healthcare providers to develop personalized care plans that improve health outcomes, enhance patient engagement, and reduce hospitalizations.

In Short

• Provide telephonic and telehealth chronic care management services for patients with multiple chronic conditions.
• Conduct comprehensive assessments and develop individualized care plans in collaboration with patients and their healthcare providers.
• Educate patients on disease management, medication adherence, lifestyle modifications, and self-care strategies.
• Coordinate with physicians, specialists, and other healthcare professionals to ensure continuity of care.
• Monitor patient progress and adjust care plans as needed to meet health goals.
• Support patients in navigating healthcare resources, scheduling follow-ups, and accessing community services.
• Utilize electronic health records (EHR) and Population Health platform to document patient interactions and maintain compliance with CMS Chronic Care Management program guidelines.
• Identify and address barriers to care, including social determinants of health.
• Participate in quality improvement initiatives to enhance patient outcomes and optimize chronic disease management programs.
• Use subject matter expertise in CCM to assist in the development of the CCM program.

Requirements

• Valid Registered Nurse (RN) license.
• Experience in chronic care management or related field.
• Strong communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proficient in using electronic health records (EHR).
• Knowledge of chronic diseases and care management protocols.
• Ability to educate and motivate patients.
• Strong organizational skills and attention to detail.
• Commitment to quality improvement and patient-centered care.
• Flexibility to adapt to changing healthcare environments.

Benefits

• Competitive salary and benefits package.
• Opportunities for professional development and continuing education.
• Supportive work environment.
• Flexible scheduling options.
• Health and wellness programs.
• Employee assistance programs.
• Paid time off and holidays.
• Retirement savings plan.
• Access to resources for career advancement.
• Collaboration with a multidisciplinary team.