Care Manager - Home Care (RN)

apartment Astrana Health location_onJohnston, RI 02919, US

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$95,000 - $100,000 / YEAR

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Care Manager - Home Care (RN)

Department: Operations

Employment Type: Full Time

Location: 1301 Atwood Avenue, Suite 206N, Johnston, RI 02919

Reporting To: Monica Kucks

Compensation: $95,000 - $100,000 / year

Description

We are seeking an experienced and compassionate Registered Nurse (RN) to join our Home Care Program as a Care Manager for high-risk patients. In this role, you will provide essential care management, conduct home visits, and offer palliative care to individuals with complex health needs, chronic illnesses, and life-limiting conditions. Your goal will be to ensure optimal care coordination, enhance patient quality of life, and provide the support necessary for patients and their families to navigate complex healthcare needs at home. You will work closely with Home Care Nurse Practitioner or Home Care Physician Assistant to help deliver care to these members.

What You'll Do

Develop and implement individualized care plans for high-risk patients, focusing on improving health outcomes and preventing hospital admissions, readmissions, and ER visits
Coordinate patient care with interdisciplinary teams, including physicians, social workers, therapists, and other healthcare professionals
Monitor patient progress, track health metrics, and adjust care plans as needed based on changes in patient condition
Provide advocacy and support to patients and families, ensuring access to necessary healthcare resources and services
Educate patients and families on disease management, self-care, medication adherence, and healthy lifestyle practices
Conduct comprehensive in-home assessments to evaluate the physical, emotional, and social needs of patients
Perform hands-on care interventions, including medication management and monitoring vital signs
Assess the home environment for safety and implement changes or recommendations to promote patient safety and independence
Provide education and training to patients and caregivers on managing chronic conditions, understanding medical treatments, and recognizing warning signs that require urgent care
Work with Home Care NP or PA to ensure that the home care plan is followed, adapting it to the patient's evolving needs and conditions
Offer in-depth education on managing chronic illnesses, medication management, and available community resources
Empower patients and their caregivers by helping them make informed decisions about their care and providing tools to manage their conditions effectively at home
Offer counseling and support to help patients and families adjust to the challenges associated with chronic illness or end-of-life care
Work closely with the multidisciplinary care team, including physicians, social workers, care coordinators, and family caregivers, to coordinate patient care
Participate in regular team meetings to discuss patient progress, challenges, and updates to care plans
Contribute to continuous improvement initiatives within the home care program to improve patient outcomes and satisfaction

Qualifications

Active and unrestricted Rhode Island RN license required
Massachusetts RN license preferred due to regional travel
Care Management Certification (CCM) preferred
Strong clinical assessment, critical thinking, and problem-solving skills.
Ability to independently manage patient care in a home setting
Excellent communication and interpersonal skills, with the ability to build trusting relationships with patients and families
Compassionate, patient-centered approach to care, especially for those with chronic or terminal illnesses
Proficiency in using electronic health records (EHR) and other office software
Knowledge of community resources, healthcare services, and support programs for patients with chronic and life-limiting conditions

Environmental Job Requirements and Working Conditions

This is a full-time position. Hours are M-F 830-5 with on-call participation.
This position operates on a hybrid, field-based capacity, where you will work predominantly in the field at patient homes, at home, and in the office on a weekly basis. The home office is located at 1301 Atwood Avenue, Suite 206 N, Johnston RI 02919.
The target pay range for this role is $95000 - $100000 per year. We also offer additional pay for on-call coverage. This salary range represents our national target range for this role.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@networkmedicalmanagement.com to request accommodation.

Additional Information:

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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