We’re unique.  You should be, too.

We’re changing lives every day.  For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts?  Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

The Community Care team is a multidisciplinary service including Registered Nurse (RN) Community Care nurses, Licensed Practical Nurse (LPN) Community Care nurses, Community Social Workers and Community Health Coordinators, who work with our highest complexity patients and their primary care physicians, to meet their medical and social needs with the aims of fully engaging them in our intensive primary care model and maximizing their healthy time at home.

The Community Care Nurse, HCT is a vital Community Care Team member who focuses on medical stabilization of our highest risk patients, typically in their homes but also during center visits and telephonic outreach. The incumbent will implement comprehensive care plans designed by our Nurse Case Managers to provide targeted education and deliver other care under the supervision of our RN community care nurses and/or primary care physicians. The incumbent establishes strong relationships with their patients, patients’ family members and caregivers, and other team members to achieve good understanding of the plans of care and achieve positive patient outcomes.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

Under the direction and supervision of a Registered Nurse (RN) provides in home and telephonic visits to patients at high-risk for hospital admission and readmission (as identified by CM Plan).  Main goal to prevent and admission or readmission to the ER/hospital.While conducting a home visit or a center visit with our patient compiles patient health information, takes and records vital statistics, takes blood pressure and conducts other basic care treatments. Records patients' medical history and other information such as test results in the medical record.Performs 4-day discharge phone call on patients discharged from a hospital, SNF, LTAC within 24-48 hours of discharge.With a physician order draws blood (phlebotomy) and collects other lab specimens.Using the medication list provided in our DASH system and approved by the physician to fill pill boxes for patients.Helps patients navigate health care systems, connecting them with community resources; orchestrates multiple facets of health care delivery and assists with administrative and logistical tasks.Assists patient and family with completion of Medicaid application for support and access to community/financial resources and refer cases to social worker as appropriate.Assesses the environment of care, e.g., safety and security, using our home safety evaluation form.Provides education with patient/family on different health concerns using standardize education directed by the Registered Nurse (RN).Coordinates the delivery of services to effectively address patient needs.Visits patient at home under the direction of the patient’s primary care physician to meet urgent patient needed.Performs other duties as assigned and modified at manager’s discretion.

KNOWLEDGE, SKILLS AND ABILITIES:Strong business acumen and experience in data analyticsExcellent verbal and written communication skills to effectively connect with diverse populations including physicians, employees, patients and their familiesTeaching abilities to conduct educational programs for PCP’s, Chen Med staff, and tier one hospital staff.Knowledge of care delivery capabilities along the continuum of careSuperb interpersonal and critical thinking skills to work productively with all levels of organization personnel and to supervise the activities of a group of employeesResourcefulness to identify prompt and sustainable solutions to barriers in care deliveryLeadership skills to direct others toward objectives that contribute to the success of the business unit. Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignmentsAbility to cope with stressful situations, manage multiple and sometimes conflicting priorities simultaneouslyFlexibility with schedule, including off-shifts, weekends and holidays to meet the needs of patients, families or staffTeaching abilities to conduct educational programs for staff and present complex data clearly and conciselyFiscal skills to monitor and control costs and revenueFamiliarity with professional and technical emerging knowledgeCompassionate with teamwork skills. Comfortable in giving group presentationsExcellent knowledge of case management principles, healthcare management and reimbursementExcellent organizational and time management skillsProficient in Microsoft Office Suite products including Excel, Word, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation softwareAbility and willingness to travel locally, regionally, and nationwide up to 30% of the timeSpoken and written fluency in EnglishBilingual preferredThis job requires use and exercise of independent judgmentEDUCATION AND EXPERIENCE CRITERIA:A valid, active Registered Nurse (RN) license in State of employment plus one of the following degree conditions is required:Bachelor’s Degree in Nursing (BSN); ORAssociate degree in Nursing (ADN) with 2 years’ home health, case management or discharge planning work experience; ORBachelor’s degree in a health-related disciplineA minimum of 5 years’ clinical work experience preferredProven working experience in Case Management:A minimum of 2 years’ utilization review and/or case management, home health and/or discharge planning experience highly desiredBLS/CPR certification for healthcare requiredPossession and maintenance of a current, valid drivers' license is required.Case Management Certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (AAMCN) preferredHospital, healthcare setting experience is preferredExperience with psychological aspects of care desiredLeadership experience in a healthcare setting highly desired (lead nurse, charge nurse, nursing supervisor, etc.)

We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better.  Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care. 

ChenMed is changing lives for the people we serve and the people we hire.  With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow.  Join our team who make a difference in people’s lives every single day.

Current Employee apply HERE

Current Contingent Worker please see job aid HERE to apply