Clinical Care Management (CCM) Manager (Registered Nurse)

This is not a flex hours job. Candidates must reside in central or eastern time zones of USA. This role does not offer immigration visa sponsorship.

Job

Responsibilities

Key Responsibilities

Team Leadership: Supervise, train, and schedule the Care Coordinators and Case Managers handling telephonic patient assessments, care plan development, and facility triage.

Quality & Escalation: Serve as the first point of escalation for complex patient care plans or high-risk clinical triage decisions.

Workflow Optimization: Monitor triage queue metrics, response times, and document auditing within the electronic medical records (EMR) system.

Liaison Work: Collaborate directly with upper executive management and the practicing Physicians/NPs to adjust clinical protocols as regional needs shift.

• Patient and Caregiver Support

Review electronic health records (EHR) to identify gaps in care for patients residing in a Long-term Care Nursing Facility.

Review and approve initial and ongoing health questionnaires completed by a member of the care management team.

Develop patient-centered care plans.

Educate patients and their durable medical power of attorney (DPOA) on the benefits of CCM.

• Provider Support

Support quality gap closure through clinical discovery

Schedule Provider visits for at-risk patients

Coordinate with the Transitional Care Manager to schedule patient visits

Ensure orders, referrals, and prior authorizations are facilitated by the virtual care support team.

Escalate abnormal diagnostic test results to providers.

• Communication Support

Communicate patient health updates to providers.

Communicate treatment plans and health updates to the patient’s caregiver in an effective and caring manner.

Primary liaison between the provider, facility and administrative support team.

Job Requirement

Must hold an active and unrestricted compact Registered Nurse (RN) License and be able to obtain additional state licenses, as needed.

Minimum of 5 years of experience as a Registered Nursing in inpatient, outpatient, or skilled nursing facilities settings.

Minimum of 2 years of Case Management experience

Certified Care Manager (CMC) or Chronic Care Professional (CCP) certification

Proficiency with various Electronic Health Records

Physical

Requirements

This is a full-time remote, work-from-home position, primarily working during standard business hours handling sensitive and confidential information. Work must be performed in a private and secure setting requiring reliable internet and phone connectivity. Ability to communicate via virtual/online meetings daily with a camera as well as being responsive in a timely manner during work hours via email, MS Teams, and phone. Ability to travel quarterly for training, meetings, and on-site visits. Ability to sit, stand, and walk for extended periods. Ability to lift and move up to 25 pounds.

EOE/M/F/Vet/Disability

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.