Experienced Telephonic RN Nurse Care Manager - Remote in Houston, TX - Leading High-Quality Home-Based Primary Care Services

Join the HarmonyCares Family: Revolutionizing Home-Based Healthcare HarmonyCares is a pioneering force in the healthcare industry, operating as one of the nation's largest home-based primary care practices. Our family of companies, including HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health, and HarmonyCares Hospice, is dedicated to delivering high-quality, coordinated healthcare services directly to patients' homes. With a mission to bring personalized, quality-based healthcare to those who have difficulty accessing care, we are transforming the way healthcare is delivered. Our Mission, Vision, and Values At HarmonyCares, our mission is to provide high-quality, coordinated healthcare in the comfort of patients' homes. Our shared vision is that every patient deserves access to quality healthcare. We uphold a set of core values that guide our actions and interactions: The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other. Why Choose HarmonyCares? We offer a comprehensive benefits package that includes: Quarterly bonuses to reward your hard work and dedication Health, dental, vision, disability, and life insurance, along with much more A 401K retirement plan with company match to help you plan for the future Tuition, professional license, and certification reimbursement to support your career growth Paid time off, holidays, and volunteer time paid to ensure work-life balance Orientation and training day time hours (no holidays/weekends) for a smooth onboarding experience Great Place to Work certified, reflecting our commitment to creating a positive work environment Established in 11 states, with over 28 years of experience in home-based primary care For more details about our benefits, please visit: https://careers.harmonycares.com/benefits. Job Summary We are seeking an experienced Telephonic RN Nurse Care Manager to join our team in Houston, TX. As a Nurse Care Manager, you will play a vital role in enhancing the health outcomes of our patients. You will manage a caseload of high-risk patients, develop and implement personalized care plans, and collaborate with the care team to ensure seamless care delivery. Key Responsibilities The following responsibilities are essential to the role of a Telephonic RN Nurse Care Manager: Care Coordination: Collaborate with the pod leader to ensure patients have access to comprehensive services tailored to their needs throughout their healthcare journey. Care Plan Development: Work with the care team to develop and manage personalized care plans, address care gaps, and engage with other resources to ensure access to care. Transition of Care: Coordinate the transition of care for patients throughout the continuum to prevent avoidable hospital admissions and ensure patient needs are met. High Risk Huddles: Coordinate and facilitate High Risk Huddles, ensuring follow-up actions are completed. Patient Prioritization: Prioritize patients based on the severity and urgency of their conditions to ensure critical cases receive immediate attention. Medical Record Review: Review medical records to identify gaps in care and coordinate services with the care team. Patient Care Plans: Regularly update patient care plans to reflect changes in patient conditions and care needs. Nursing Assessments: Perform thorough nursing assessments via telephone to maximize or improve current health outcomes. Patient Education: Provide education to patients and/or their caregivers on disease management, medication, health maintenance, and disease prevention. Documentation: Document necessary interactions, assessments, updates, etc., in patient medical records according to processes and guidelines. Communication: Serve as a liaison between patients, providers, resources, etc., to ensure seamless care delivery. Requirements and Qualifications To be successful in this role, you will need: Essential Qualifications: Active Registered Nurse License: Current RN license in the state of practice. Care Management Experience: 2+ years of experience in care management within community, health plan, or hospital systems. Clinical Skills: Strong clinical skills and proactive thinking. Communication Skills: Effective communication skills, both written and verbal. Telephone Assessment: Ability to perform extensive telephone assessments. Medicare Regulations: Knowledge of Medicare regulations and home care and hospice standards. Presentation Skills: Experience with small group presentations and teaching/training. Interpersonal Skills: Exhibits excellent interpersonal skills. Computer Skills: Working knowledge of computer programs (email, Word, Excel, PowerPoint, etc.). Time Management: Ability to manage time effectively to ensure all duties and documentation requirements are completed in a timely manner. Preferred Qualifications: Bachelor of Science in Nursing: Bachelor's degree in nursing or a related field. Multi-State Licensing: May be required to obtain multi-state licensing. Population Health: Strong knowledge of population health, quality measures, care gap closure, and value-based care models. Career Growth and Learning Benefits At HarmonyCares, we are committed to the growth and development of our employees. We offer: Opportunities for professional advancement within the organization Training and development programs to enhance your skills and knowledge A collaborative and supportive work environment that encourages learning and innovation Work Environment and Company Culture Our work environment is dynamic and supportive, with a strong emphasis on teamwork and collaboration. We value diversity and inclusion, and strive to create a workplace where everyone feels valued and respected. Compensation and Benefits We offer competitive compensation and a comprehensive benefits package, including: Competitive salary range Quarterly bonuses Health, dental, vision, disability, and life insurance 401K retirement plan with company match Paid time off and holidays How to Apply If you are a motivated and compassionate RN looking to make a difference in the lives of patients, we encourage you to apply for this exciting opportunity. Please submit your application through our careers website: Apply Job! or Apply to this Job. We look forward to hearing from you and exploring how you can join our team! Apply for this job