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Nurse Case Manager in Rhode Island at Prospect Medical Systems

Date Posted: 8/16/2018

Job Snapshot

Job Description

Nurse Case Manager

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Nurse Case Manager will have the opportunity to work on and promote team based interdisciplinary healthcare in a primary care setting. The nurse care manager (NCM) plays an integral role in the success of a PCMH practice site. The NCM/CC has direct, frequent or face-to-face contact with identified high risk members, as well as frequent interactions with clinical and non-clinical staff in the practice and in the community. He/she is charged with setting up and implementing the primary care medical home care model and administering evidence based health care in a new and innovative way. The nurse case manager is responsible for providing comprehensive screenings, assessment, care coordination services, disease education and self-management support with patients who have chronic conditions- with particular attention but not limited to coronary artery disease, depression, and diabetes. The Nurse Case Manager will be integrated into the office-based healthcare team to work in partnership to promote patient centered care, frequent contact with primary care providers and medical home team members, and actively participate in interdisciplinary patient centered team meetings across the continuum of care.

Job Responsibilities/Duties

  • Provide primary care management services for identified high risk members, as defined by the IPA, Payer, or other applicable entity, including assessment, care plan development, and member education;
  • Act as a liaison between members, providers, community resources, and Payers;
  • Facilitate effective transitions of care through timely communication of necessary information for patient care and discharge planning;
  • Coordinate, directly or with the clinical team, community resources for patients and caregivers;
  • Conduct medication reconciliation as appropriate and communicate any needed adjustments to care team and providers;
  • Completes initial patient assessment, including a comprehensive medical, psychosocial, and functional assessment of the patient, including in office or home setting as needed; review with provider and clinical team members.
  • Provides detailed education about patient's specific chronic illness, including the pathology, signs and symptoms, complications and medications used in treatment
  • Assures that screening tests, immunizations and urgent referrals are up to date; perform outreach when additional action is needed.
  • Utilizes an interdisciplinary team approach to address opportunities to plan and coordinate care; acts in a supportive capacity to other team members (i.e. medical assistants, receptionist, office manager, provider, behavioral health provider etc.) in supporting patient and the treatment plan
  • Helps to arrange contact with other resources needed to support the treatment plan
  • Develops care management plans, interventions, and a treatment goals in collaboration with patient/family; utilizes motivational interviewing techniques to assist patients with establishing self-management goals, and action plans with timeframes.


Minimum Education: RN from an accredited program.

Minimum Experience: Three (3) to five (5) years' experience in community health setting, public health, chronic disease management, community nursing, case management preferred. Experience working with primary care providers to coordinate care and disease management.Experience working with patients regarding their care coordination and disease management/education is preferred.

Req. Certification/Licensure:  RN license in the State of Rhode Island.

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

How to Apply

To apply for this role, or search our other openings, please visit and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law:

Keywords: Case Manager, RN, Nurse, Utilization Review, Case Management


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