Care Manager - Home Care (Registered Nurse)

Department: Operations

Employment Type: Full Time

Location: 1301 Atwood Avenue, Suite 206N, Johnston, RI 02919

Reporting To: Monica Kucks

Compensation: $95,000 - $100,000 / year

Description

We are seeking an experienced and compassionate Registered Nurse (RN) to join our Home Care Program as a Care Manager for high-risk patients. In this role, you will provide essential care management, conduct home visits, and offer palliative care to individuals with complex health needs, chronic illnesses, and life-limiting conditions. Your goal will be to ensure optimal care coordination, enhance patient quality of life, and provide the support necessary for patients and their families to navigate complex healthcare needs at home. You will work closely with Home Care Nurse Practitioner or Home Care Physician Assistant to help deliver care to these members.

What You'll Do

• Develop and manage individualized care plans for high-risk patients, focusing on improving outcomes, preventing hospital/ER visits, and adapting plans as conditions evolve.
• Coordinate care across interdisciplinary teams (physicians, NPs/PAs, social workers, therapists, care coordinators, and family caregivers) through regular collaboration and case reviews.
• Conduct comprehensive in-home assessments to evaluate physical, emotional, and social needs, while ensuring home safety and patient independence.
• Deliver direct patient care and interventions, including medication management, monitoring vitals, and supporting chronic condition management.
• Educate and empower patients and families on disease management, self-care, medication adherence, healthy lifestyles, recognizing warning signs, and using available community resources.
• Provide advocacy, counseling, and support to patients and families, addressing barriers to care, adjustment to chronic illness, or end-of-life challenges.
• Contribute to program improvement efforts to enhance patient outcomes, satisfaction, and overall quality of home care services.

Qualifications

• Active and unrestricted Rhode Island RN license required
• Massachusetts RN license preferred due to regional travel
• Care Management Certification (CCM) preferred
• Strong clinical assessment, critical thinking, and problem-solving skills.
• Ability to independently manage patient care in a home setting
• Excellent communication and interpersonal skills, with the ability to build trusting relationships with patients and families
• Compassionate, patient-centered approach to care, especially for those with chronic or terminal illnesses
• Proficiency in using electronic health records (EHR) and other office software
• Knowledge of community resources, healthcare services, and support programs for patients with chronic and life-limiting conditions

Environmental Job Requirements and Working Conditions

• This is a full-time position. Hours are M-F 830-5 with on-call participation. 
• This position operates on a hybrid, field-based capacity, where you will work predominantly in the field at patient homes, at home, and in the office on a weekly basis. The home office is located at 1301 Atwood Avenue, Suite 206 N, Johnston RI 02919. 
• The target pay range for this role is $95,000 - $100,000 per year. We also offer additional pay for on-call coverage. This salary range represents our national target range for this role.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@networkmedicalmanagement.com to request accommodation. 
 
Additional Information:  
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.