Registered Nurse - APCM

In the U.S., 60% of adults – more than 133 million people – live with at least one chronic condition. These patients need frequent, proactive support to stay healthy, yet our care system isn’t built for that level of attention. With rising clinician shortages, strained infrastructure, and reactive care models, patients too often end up in the ER or the hospital when those outcomes could have been prevented.

At Cadence, we’re building a better system. Our mission is to deliver proactive care to one million seniors by 2030. Our technology and clinical care team extend the reach of primary care providers and support patients every day at home. In partnership with leading health systems, Cadence consistently monitors tens of thousands of patients to improve outcomes, reduce costs, and help patients live longer, healthier lives.

Cadence Health is seeking a Care Management Registered Nurse to support patients enrolled in our Advanced Primary Care Management (APCM) program. In this role, you will proactively monitor patient data, evaluate clinical information, and deliver timely interventions to promote patient safety and improved health outcomes. You will work closely with interdisciplinary care teams to reinforce care plans, support medication adherence, close care gaps, and provide patient education that empowers individuals to actively manage their health and chronic conditions.

Licensure Requirements

• Active Compact Multi-State RN license is required
• An active Hawaii RN License

Schedule Requirements:

• This role requires availability Monday - Friday.
• Schedule hours are 8:00 AM to 5:00 PM Hawaii Time

What you'll do:

• Proactively monitor patient vitals, symptoms, and relevant clinical data to identify care gaps and patients who require timely intervention.
• Develop, implement, and manage individualized care plans aligned with physician recommendations and patient-specific health goals.
• Engage with patients via phone and secure messaging to address concerns, manage escalations, and provide empathetic, responsive clinical support.
• Conduct virtual follow-up visits to support program onboarding, adjust care plans, reinforce medication adherence, and help patients progress toward lifestyle and health goals.
• Document all clinical interactions accurately and efficiently, and prepare clear care summaries for patients’ primary care providers to ensure seamless coordination.
• Partner with interdisciplinary care teams to deliver high-quality, patient-centered care across chronic conditions such as CHF, hypertension, and type 2 diabetes.
• Contribute to the development and refinement of clinical workflows and processes to support efficient, scalable, and high-impact care management programs.
• Represent Cadence’s commitment to exceptional care in every patient interaction, aligning with the standards and goals of our health system partners.
  

What you'll need:

• Multi-state RN Compact State Licensure and a single state RN license in Hawaii. 
• Associate Degree in Nursing Science.
• 5+ years of recent clinical experience as an RN in an ICU/ER setting is preferred. 
• Prior experience supporting patients in a chronic care management program is a plus.
• To ensure that our clinicians have the necessary tools for a successful remote work environment, home office setups must have consistently stable wifi with strong upload and download speeds. A wifi speed test is required before participating in the interview process to verify that these standards are met.
• Skilled in nursing processes.
• Excellent clinical acumen.
• Exceptional written, verbal, and interpersonal communication skills.
• EMR experience, preferably in Athena and EPIC.
• Works effectively with minimum supervision.
• Strong collaboration with cross-functional partners.
• Ability to support the delivery of health care to patients by performing a variety of activities and procedures that are prescribed by and performed under the direction of the Cadence Nurse Practitioner and Cadence clinical policies and procedures.
• Patient assessment competency.
• Technical fluency with the ability to work in multiple platforms and systems, including Notion, Athena, EPIC, Zendesk, and G Suite.