Hopscotchprimarycare
Care Manager Registered Nurse
Western North Carolina . Posted 18 days ago
The role
The Care Manager Registered Nurse manages a panel of high-acuity patients through remote case management and in-clinic support. This role focuses on reducing avoidable admissions, improving clinical outcomes, and supporting care continuity.
What you will do
- Manage a defined panel of high-risk patients through longitudinal case management
- Develop, implement, and update individualized care plans with providers and care teams
- Perform telephonic outreach and monitoring
- Coordinate care across providers, specialists, hospitals, EDs, SNFs, and community resources
- Partner with transitions of care team for smooth patient transitions
- Partner with providers, MAs, LPNs, and Care Center Managers to align on care plans
- Escalate clinical concerns and barriers to care in real time
- Participate in team huddles, case reviews, and interdisciplinary care discussions
- Track and improve quality and utilization metrics
- Support high-risk patient visits and assist with care coordination in-clinic
Required qualifications
- Minimum of 2 years of experience as a care manager embedded into an interdisciplinary team
- Active registered nurse (RN) license in North Carolina
- BLS certification
- Experience working in a primary care clinic focused on chronic disease management
- Experience with motivational interviewing, behavior change, health promotion, and coaching
- Strong verbal and written communication skills
- Customer service orientation
Nice to have
- Experience with behavioral health and community-based organizations
About the company
Hopscotch Primary Care is on a mission to transform healthcare in rural America. They provide high-quality primary care through a robust care model and comprehensive care team.