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Join to apply for the
Nurse Care Manager
role at
TieTalent 1 day ago Be among the first 25 applicants Join to apply for the
Nurse Care Manager
role at
TieTalent Company Overview:
Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health! About
Company Overview:
Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health!
Job Title & Role Description
The
Nurse Care Manager
is responsible for comprehensive care coordination for high-risk patients in Contra Costa County. This role focuses on care planning, emergency department (ED) avoidance, and discharge planning for patients transitioning between levels of care. The Nurse Care Manager will work closely with patients, caregivers, health plans, and primary care providers to facilitate seamless care across settings and ensure continuity of services.
This is a hybrid position with the autonomy to visit patients in their homes or at the hospital, as clinically appropriate. Additionally, the Nurse Care Manager will lead interdisciplinary team (IDT) meetings with a clinical focus to align care plans and support patient-centered outcomes.
Skills Required
Active, unrestricted Registered Nursing (RN) license in California Minimum of 3-5 years of case management experience, including care planning and coordination Strong knowledge of POLST, Advance Directives, and end-of-life planning Experience with home health, hospice, and care transitions Proficiency in electronic health record (EHR) systems and digital care management tools Excellent communication and patient education skills Critical thinking and decision-making abilities in complex care management Ability to work independently Experience collaborating with health plans, PCPs, and community resources
Key Behaviors
Patient-Centered Care:
Develops strong relationships with patients and caregivers, advocating for their needs and ensuring they understand and follow care plans.
Collaboration
Effectively coordinates care with the patient’s health plan, primary care provider, and other care team members to optimize health outcomes.
Proactive Communication
Actively engages patients and caregivers within 48 hours of hospital discharge to assess needs, update care plans, and mitigate potential readmission risks.
Advocacy And Education
Provides clear, compassionate education to patients and families regarding POLST, Advance Directives, and available support services.
Care Coordination
Ensures that care is effectively coordinated across multiple providers and services, particularly during transitions of care.
Time Management
Efficiently manages patient caseloads, balancing multiple tasks while adhering to established deadlines and care plans.
Problem Solving
Identifies potential gaps in care, collaborates with providers to resolve issues, and implements strategies to optimize patient outcomes.
Confidentiality
Maintains patient confidentiality and follows HIPAA regulations in all communications and documentation.
Cultural Competence
Demonstrates respect for diversity, providing culturally sensitive care that meets the needs of diverse patient populations.
Competencies
Clinical Expertise:
Strong knowledge of chronic disease management, care transitions, and evidence-based practices to develop and implement care plans.
Effective Communication
Skilled at delivering complex medical information clearly to patients, caregivers, and interdisciplinary teams.
Care Plan Development
Proficient in creating personalized care plans that address physical, behavioral, and social health needs.
Technology Proficiency
Ability to use electronic health records (EHR) and care management systems to document, track, and coordinate patient care.
Outcome-Oriented
Focused on achieving optimal clinical and financial outcomes for patients through effective care coordination and management.
Independent And Team-Oriented
Able to work independently while also collaborating effectively with a multidisciplinary team.
Critical Thinking
Uses clinical judgment to assess, analyze, and evaluate patient progress, adapting care plans as needed to achieve optimal results.
Multitasking And Prioritization
Manages multiple patient cases simultaneously while prioritizing tasks to meet deadlines and ensure comprehensive care.
Patient Engagement
Motivates patients to follow care plans and improve self-care skills through regular communication and support.
Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.
Compensation details:
100000-105000 Yearly Salary
PI093d5c456226-37648-37537710
San Francisco, California
Languages
English
Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
Job function Health Care Provider Industries Technology, Information and Internet Referrals increase your chances of interviewing at TieTalent by 2x Sign in to set job alerts for “Nursing Manager” roles.
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Nurse Care Manager
role at
TieTalent 1 day ago Be among the first 25 applicants Join to apply for the
Nurse Care Manager
role at
TieTalent Company Overview:
Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health! About
Company Overview:
Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health!
Job Title & Role Description
The
Nurse Care Manager
is responsible for comprehensive care coordination for high-risk patients in Contra Costa County. This role focuses on care planning, emergency department (ED) avoidance, and discharge planning for patients transitioning between levels of care. The Nurse Care Manager will work closely with patients, caregivers, health plans, and primary care providers to facilitate seamless care across settings and ensure continuity of services.
This is a hybrid position with the autonomy to visit patients in their homes or at the hospital, as clinically appropriate. Additionally, the Nurse Care Manager will lead interdisciplinary team (IDT) meetings with a clinical focus to align care plans and support patient-centered outcomes.
Skills Required
Active, unrestricted Registered Nursing (RN) license in California Minimum of 3-5 years of case management experience, including care planning and coordination Strong knowledge of POLST, Advance Directives, and end-of-life planning Experience with home health, hospice, and care transitions Proficiency in electronic health record (EHR) systems and digital care management tools Excellent communication and patient education skills Critical thinking and decision-making abilities in complex care management Ability to work independently Experience collaborating with health plans, PCPs, and community resources
Key Behaviors
Patient-Centered Care:
Develops strong relationships with patients and caregivers, advocating for their needs and ensuring they understand and follow care plans.
Collaboration
Effectively coordinates care with the patient’s health plan, primary care provider, and other care team members to optimize health outcomes.
Proactive Communication
Actively engages patients and caregivers within 48 hours of hospital discharge to assess needs, update care plans, and mitigate potential readmission risks.
Advocacy And Education
Provides clear, compassionate education to patients and families regarding POLST, Advance Directives, and available support services.
Care Coordination
Ensures that care is effectively coordinated across multiple providers and services, particularly during transitions of care.
Time Management
Efficiently manages patient caseloads, balancing multiple tasks while adhering to established deadlines and care plans.
Problem Solving
Identifies potential gaps in care, collaborates with providers to resolve issues, and implements strategies to optimize patient outcomes.
Confidentiality
Maintains patient confidentiality and follows HIPAA regulations in all communications and documentation.
Cultural Competence
Demonstrates respect for diversity, providing culturally sensitive care that meets the needs of diverse patient populations.
Competencies
Clinical Expertise:
Strong knowledge of chronic disease management, care transitions, and evidence-based practices to develop and implement care plans.
Effective Communication
Skilled at delivering complex medical information clearly to patients, caregivers, and interdisciplinary teams.
Care Plan Development
Proficient in creating personalized care plans that address physical, behavioral, and social health needs.
Technology Proficiency
Ability to use electronic health records (EHR) and care management systems to document, track, and coordinate patient care.
Outcome-Oriented
Focused on achieving optimal clinical and financial outcomes for patients through effective care coordination and management.
Independent And Team-Oriented
Able to work independently while also collaborating effectively with a multidisciplinary team.
Critical Thinking
Uses clinical judgment to assess, analyze, and evaluate patient progress, adapting care plans as needed to achieve optimal results.
Multitasking And Prioritization
Manages multiple patient cases simultaneously while prioritizing tasks to meet deadlines and ensure comprehensive care.
Patient Engagement
Motivates patients to follow care plans and improve self-care skills through regular communication and support.
Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.
Compensation details:
100000-105000 Yearly Salary
PI093d5c456226-37648-37537710
San Francisco, California
Languages
English
Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
Job function Health Care Provider Industries Technology, Information and Internet Referrals increase your chances of interviewing at TieTalent by 2x Sign in to set job alerts for “Nursing Manager” roles.
San Ramon, CA $98,260.00-$205,260.00 2 months ago Director Clinical Quality Improvement (CA Registered Nurse License)
San Ramon, CA $150,000.00-$210,000.00 1 month ago Nurse Manager - Mobile & Street Medicine
Registered Nurse, Care Manager and Wellness Coach
Director of Nursing - Operating Room / Surgical
San Ramon, CA $98,260.00-$205,260.00 2 months ago Assistant Patient Care Manager (RN) - RWC Outpatient Pre/Post Care (Full-Time, 10-Hour Day Shifts)
Hayward, CA $88,753.60-$99,905.40 11 hours ago Registered Nurse Manager, Care Coordination, Full Time
Assistant Patient Care Manager (RN) - RWC Outpatient Pre/Post Care (Full-Time, 10-Hour Day Shifts)
San Ramon, CA $135,000.00-$200,000.00 5 months ago Travel Home Health Case Manager RN - $2,909 per week
Greenbrae, CA $3,256.00-$3,256.00 4 days ago School-Based Registered Nurse (RN) - Hayward, California
Registered Nurse - Pediatric Med/Surg Float
Travel Registered Nurse Cardiac Cath Lab
Walnut Creek, CA $2,564.60-$2,564.60 4 days ago Nurse Manager - Bone Marrow Transplant Program
Clinical Services Manager I/II - Cordilleras Health and Healing Center
San Mateo County, CA $133,764.80-$193,544.00 1 week ago Manager Ambulatory Oncology and Specialty Operations - Full Time - 8 hour - Variable Days
Walnut Creek, CA $176,276.00-$264,415.00 1 month ago San Francisco, CA $30.00-$36.00 6 months ago Registered Nurse/Pediatric Acute Care Float Pool
Sr. Program Manager – Clinical Construction
Oakland, CA $124,400.00-$291,600.00 5 months ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr