RN Nurse Care Manager – Hybrid

HarmonyCares

. Manage a caseload of high-risk patients and their care barriers .

Posted 10/8/2026full-timeRemote • Michigan • United StatesJuniorMid-Level💰 $73,606 - $81,022 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management, including Transitional Care Management and Chronic Care Management, while effectively coordinating patient care and addressing care gaps. Strong clinical skills and communication abilities are essential for educating patients and facilitating transitions across the healthcare continuum.

Highest-signal resume keywords

Active Registered Nurse LicenseCare Management ExperienceTelephone Nursing AssessmentKnowledge of Medicare RegulationsPopulation Health Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Transitional Care ManagementChronic Care ManagementDisease Management EducationMedication EducationPatient Care Plan DevelopmentMedical Record ReviewCare Gap ClosureQuality MeasuresValue-Based Care ModelsTime Management

Soft Skills

Effective CommunicationProactive ThinkingInterpersonal SkillsTeaching/Training SkillsWritten and Oral Skills

Tools & Technologies

EmailWordExcelPowerPoint

Certifications & Qualifications

Registered Nurse LicenseMulti-State Licensing (Preferred)

Industry Keywords

High-Risk PatientsCare BarriersHealthcare ContinuumAvoidable Hospital AdmissionsHigh Risk HuddlesPatient EducationHome Care StandardsHospice Standards

About the role

Key responsibilities & impact

Manage a caseload of high-risk patients and their care barriers
Perform Transitional Care Management, Chronic Care Management, Disease Management Education, and Medication Education
Develop and manage patient care plans
Serve as co-chair of the pod alongside the pod leader, focusing on prioritizing patient needs and improving outcomes
Coordinate care services with the pod leader and care team
Address care gaps and engage resources to ensure access to care
Coordinate transitions across the healthcare continuum and help prevent avoidable hospital admissions
Facilitate High Risk Huddles and ensure follow-up actions are completed
Prioritize patients based on condition severity and urgency
Review medical records to identify gaps in care
Perform telephone nursing assessments
Educate patients and caregivers on disease, medication, health maintenance, and prevention
Document interactions, assessments, and updates in medical records
Liaise between patients, providers, and resources
Communicate patient status and care plans during transitions between home, hospital, post-acute care, and home

Requirements

What you’ll need

Active Registered Nurse License
2+ years of care management experience in community, health plan or hospital systems
Possesses strong clinical skills and proactive thinking
Effective communication skills
Ability to perform extensive telephone assessment
Knowledge of Medicare regulations and home care and hospice standards
Experience with small group presentations and teaching/training
Exhibits excellent interpersonal skills
Exhibits excellent written and oral skills
Working knowledge of computer programs (email, Word, Excel, PowerPoint, etc.)
Manages time effectively to ensure all duties and documentation requirements are completed in a timely manner
May be required to obtain multi-state licensing
Preferred: Bachelor of Science in nursing or related field
Preferred: Strong knowledge of population health, quality measures, care gap closure and value-based care models

Benefits

Comp & perks

Quarterly Bonuses
Health, Dental, Vision, Disability & Life Insurance
401K Retirement Plan (with company match)
Tuition, Professional License and Certification Reimbursement
Paid Time Off, Holidays and Volunteer Time Paid
Orientation and Training Day Time Hours (no holidays/weekends)