RN ECM Primary Care Clinic
- Outpatient
- 1.0 Corona, CA Job Details Full-time $37
- $47 an hour 3 hours ago Benefits Health insurance Dental insurance Paid time off Vision insurance Qualifications Teamwork RN License Bachelor of Science Associate's degree Associate Degree in Nursing Full Job Description We are seeking a dedicated, compassionate, and experienced Registered Nurse (RN) to join our Enhanced Care Management (ECM) team serving IEHP members.
The RN will provide clinical oversight, care coordination, patient education, and support for individuals with complex medical, behavioral health, and social needs. Working closely with providers, Community Health Workers, social service agencies, and interdisciplinary care teams, the RN will help improve health outcomes, reduce hospitalizations, and ensure patients receive comprehensive, patient-centered care. This position is ideal for a nurse who is passionate about population health, care management, health equity, and helping vulnerable populations navigate the healthcare system. Duties & Responsibilities Conduct comprehensive nursing assessments for ECM members with complex medical and psychosocial needs Develop, implement, and monitor individualized care plans in collaboration with providers and interdisciplinary care teams Perform medication reconciliation and provide medication education to patients and caregivers Review hospital discharge summaries, emergency room visits, and specialist recommendations to ensure continuity of care Coordinate care transitions following hospitalizations, skilled nursing facility stays, rehabilitation admissions, and emergency department visits Monitor chronic conditions such as diabetes, hypertension, COPD, CHF, and behavioral health conditions Identify and address barriers to care, including social determinants of health, transportation challenges, food insecurity, housing instability, and financial hardships Collaborate with physicians, nurse practitioners, behavioral health providers, Community Health Workers (CHWs), social workers, and community-based organizations Provide patient and caregiver education regarding disease management, preventive care, medication adherence, and self-management strategies Assist patients in accessing specialty care, behavioral health services, home health services, durable medical equipment, and community resources Conduct telephonic and in-person patient outreach and follow-up Participate in interdisciplinary case conferences and quality improvement initiatives Maintain accurate and timely documentation in the electronic health record (EHR) and ECM platforms Ensure compliance with IEHP, CalAIM, Medi-Cal, and organizational policies and procedures Support quality metrics, patient engagement goals, and care management program objectives Qualifications Current and unrestricted California Registered Nurse (RN) license required Associate Degree in Nursing (ADN) required; Bachelor of Science in Nursing (BSN) preferred Minimum of 2 years of nursing experience required Experience in case management, care coordination, population health, home health, primary care, managed care, hospice, or community health preferred Experience working with Medi-Cal, CalAIM, IEHP, or managed care populations strongly preferred Knowledge of chronic disease management, care transitions, and social determinants of health Strong clinical assessment and critical thinking skills Familiarity with electronic health records (EHRs) and care management platforms Excellent communication, organizational, and problem-solving abilities Ability to work independently while collaborating effectively within a multidisciplinary team Bilingual English/Spanish preferred Preferred Experience Enhanced Care Management (ECM) CalAIM Programs Complex Case Management Population Health Management Transitional Care Management Utilization Management Home Health or Community-Based Nursing Behavioral Health Integration Schedule Full-Time Monday
PM No Weekends Pay:
$37.00
00 per hour
Benefits:
Dental insurance Health insurance Paid time off Vision insurance
Work Location:
In person
