Clinical Corp Shared Services - Chronic Disease Management Nurse

ArchWell Health - Phoenix, AZ

Job Title: Clinical Corp Shared Services - Chronic Disease Management Nurse

Position: Nurse responsible for care management services for patients with complex chronic conditions

Job Type: Full Time

Pay:

Shift:

Work Type: On-Site

Address:

City: Phoenix

State: AZ

ZIP Code:

Assess the physical, functional, social, psychological, environmental, learning and financial needs of patients.
Identify problems, goals and interventions designed to meet patient’s needs surrounding management of complex chronic medical conditions.
Create care plans including problems, goals and interventions designed to meet patient’s needs.
Implement and monitor the care plan to ensure effectiveness and appropriateness of services.
Evaluate patient’s progress toward goal achievement, including identification and evaluation of barriers.
Provide intensive disease state education, direction, and support to achieve member self-care competence.
Utilize motivational interviewing skills to build patient engagement in care management plan.
Act as a patient advocate and assist with addressing barriers to care or compliance with the care plan.
Collaborate with Social Worker by referring patients for SDOH needs and monitoring outcomes.
Engage in professional development activities to keep abreast of care management practices.
Establish trusting relationships with patients, families, or caregivers.
Communicate telephonically with hospital case managers, PT, social workers, patients, and families to facilitate discharge plans.
Willingness to travel up to 50% regional to enhance collaboration with care team.

Subject matter expert in chronic medical conditions (e.g., Chronic Lung Disease, Heart Failure, Diabetes, Chronic/End Stage Kidney Disease)
Ability to plan, implement and evaluate patient specific care plans
Experience with monitoring, assessing, recording, and adjusting care plans
Excellent verbal and written communication skills
Strong organizational skills
Experience in a collaborative team environment
Proficient computer skills including Microsoft Office

Experience: Minimum of 2 years’ clinical work experience, 2 years’ case management experience, 1 year experience in disease management

Education: Associate degree in Nursing required; BSN preferred

License & Certification:

Valid, active, unrestricted Registered Nurse (RN) license in State of employment required
Willingness to obtain an RN license in other states with ArchWell Health center

Schedule:

COVID-19 Requirements: Not Specified

ArchWell Health is an equal opportunity employer.
Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.