chronic care nurse

University of North Dakota

<p></p><div><div><div><div><div><div><div><div><div><div><div><div>CATEGORIES: <div>Health Care/ Social Services</div></div>
<div>
DEPARTMENT: <div>Bismarck CFM</div></div>
</div></div></div><div><div><div><div><p>Chronic Care Nurse</p>
 <div></div><div><div><ul><li>498066
</li> </ul></div><div></div><div><ul><li>Bismarck, North Dakota, United States
</li> </ul></div><div></div><div><ul><li>Part-time Staff
</li> </ul></div><div></div><div><ul><li>Closing on: May 14 2026
</li> </ul></div></div><div></div><div><div><div><b>ADD TO FAVORITES
</b></div></div><div></div><div><b>
</b></div></div><div><p>Salary/Position Classification</p>
<ul><li>$32.00-$35.00 hourly, Non-Exempt (Eligible for overtime)</li>
<li>19 hours per week</li>
<li>100% Remote Work Availability: No</li>
<li>Hybrid Work Availability (requires some time on campus): No</li>
</ul><p>Purpose of Position</p>
<p>
A Chronic Care Nurse plays a vital role in the healthcare system by providing specialized care and support to individuals managing long-term health conditions. These dedicated nurses work closely with patients to develop personalized care plans aimed at improving their quality of life, managing symptoms, and preventing complications. Their responsibilities encompass a wide range of activities, including patient education on medication management, lifestyle modifications, and self-care techniques. Chronic Care Nurses often act as intermediaries between patients and other healthcare providers, ensuring seamless communication and coordinated care. They conduct regular assessments to monitor the progression of the disease and adjust treatment plans as needed. By offering continuous support and resources, these nurses empower patients to take an active role in their own health. Their expertise not only alleviates the burden of chronic illnesses but also helps reduce hospital readmissions and enhance overall patient outcomes. Integrating compassion with clinical skills, Chronic Care Nurses are essential advocates for patients navigating the complexities of chronic disease management.</p>
<p>
Duties &amp; Responsibilities</p>
<ul><li>In collaboration with the provider, develop and implement individualized care plans for patients with chronic conditions.
<ul><li>Monitor and evaluate patient progress and adjust care plans as necessary.</li>
<li>Educate patients and their families about disease management and prevention strategies.</li>
<li>Coordinate with other healthcare professionals to ensure comprehensive care.</li>
<li>Administer medications and treatments as prescribed by physicians.</li>
<li>Perform routine assessments and document patient outcomes.</li>
<li>Assist in the development and implementation of chronic disease management programs.</li>
<li>Complete follow up phone calls to chronic care patients.</li>
<li>Complete phone calls for hospital follow up and transitional care management patients</li>
<li>Document and communicate nursing interventions and patient responses to appropriate members of the health care team.</li>
<li>Documentation is completed in patient&rsquo;s electronic chart as per established protocol(s).</li>
<li>Electronically refill prescriptions to pharmacy as ordered by physician with accuracy.</li>
<li>Reports and tracks laboratory test results, and other diagnostic testing as indicated by Risk Management Policies and Procedures.</li>
<li>Ensure compliance with healthcare regulations and best practices.</li>
</ul> </li><li>Participates in quality improvement activities.
<ul><li>Attend meetings, seminars, and conferences as appropriate.</li>
<li>Complete accurate and timely third-party payer prior authorization requests, through payer portals or by phone and follow up consistently on pending cases.</li>
</ul></li></ul><p>Required Competencies</p>
<ul><li>Excellent interpersonal skills and ability to work closely with faculty and resident physicians.</li>
<li>Ability to work with patients and the public in a professional, confidential, and calm fashion.</li>
<li>Strong oral and written communications skills.</li>
<li>Strong computer skills with experience in electronic health records.</li>
<li>Ability to adhere to clinic safety protocols</li>
<li>Ability to adhere to clinic policies and procedures</li>
</ul><p>Minimum Requirements</p>
<ul><li>Associate's degree in nursing or equivalent.</li>
<li>Successful completion of a Criminal History Background Check</li>
</ul>
<p>In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the US and to complete the required employment eligibility verification form upon hire. <b><i>This position does not support visa sponsorship for continued employment.</i></b></p>
<p>
Preferred Qualifications</p>
<ul><li>Three years of nursing experience in a clinical setting</li>
<li>Experience with care coordination and chronic care management.</li>
<li>Epic electronic health record experience</li></ul><br>
<p></p>
<p>
</p></div></div></div></div></div><div><div><div><p><b>Please note, all employment postings close at 11:55pm CST. Part-time/Temporary positions are posted for a minimum of 3 business days.</b></p></div></div></div></div><div></div><div><div><div><div><br>
</div></div></div><div></div><div><div><div><div><p>Other UND Career Openings</p>
</div></div><div></div><div><div><div><p>Associate Professor or Professor, Tenure-track, Nursing</p>
<b>Grand Forks, North Dakota, United States</b><b>Nursing</b>
<div></div><div>The department of Nursing at the University of North Dakota is seeking a tenure-track associate professor or professor to teach, conduct research and perform service.</div>
</div><div><p>Part-time Clinical Instructor - Nursing</p>
<b>Grand Forks, North Dakota, United States. Remote, North Dakota, United States</b><b>Nursing</b>
<div></div><div>The UND graduate nursing department is seeking a part-time faculty member to teach in the Psych-Mental Health Nurse Practitioner (PMHNP) program.</div>
</div><div><p>Assistant or Associate Professor, Medical Laboratory Science</p>
<b>Grand Forks, North Dakota, United States</b><b>Medical Laboratory Science</b>
<div></div><div>The UND Department of Medical Laboratory Science invites applications for open faculty positions. Join our team and become an integral part of the education of future laboratory professionals!</div>
</div></div></div></div></div></div></div></div></div></div></div><div></div><div><div><div><div><div><div><div><div><div><p>Additional Information</p>
<p>
Find out why Grand Forks is Cooler.</p>
<p>
All information listed in this position announcement will be used by Human Resources, the Hiring Department, and EO/Title IX for screening, interviewing and selection purposes.</p>
</div></div></div></div><div><div><div><div><p>Need help?</p>
<p>
Please email the Human Resources Department at UND.humanresources@UND.edu or contact us by phone at 701.777.4226. If you anticipate needing any type of accommodation to participate in any portion of the University's employment process, including completion of the online application process, please contact our office in advance of your participation or visit.</p>
</div></div></div></div><div><div><div><div><p>Veteran&rsquo;s Preference</p>
<p>
Veterans claiming preference must submit all proof of eligibility by the closing date. Proof of eligibility includes a DD-214 or a copy of NGB 22 from National Guard or Reserve (with a unit located in ND) or certification from the applicant's unit command that the individual is expected to be discharged or released from active duty in the uniformed services under other than dishonorable conditions not later than one hundred twenty days after the date of the submission of the certification. If claiming disabled veteran status, proof of eligibility includes a DD-214 and a current letter of disability dated within the past year.</p>
</div></div></div></div></div></div></div></div></div><div><div><div><div><div><div><div><div><div><p>Confidentiality of Application Materials</p>
<p>
Pursuant to NDCC 44-04-18.27, applications and any records related to the applications that identify an applicant are confidential, except records related to the finalists of the position, which are open to the public after the search committee has identified the top three or more finalists who will be invited to campus.</p>
</div></div></div></div><div><div><div><div><p>EEO Statement</p>
<p>
The University of North Dakota is an equal opportunity employer (veteran/disability). All qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristic. Veterans and individuals with disabilities are encouraged to apply.</p>
</div></div></div></div><div><div><div><div><p>Clery Statement</p>
<p>
In compliance with the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, the University of North Dakota publishes an Annual Security and Fire Safety Report. The report includes the university&rsquo;s policies, procedures, and programs concerning safety and security, as well as three years of crime statistics for our campus. As a prospective employee, you are entitled to a copy of this report. The report and statistical data can be found online at UND.edu. You may also request a paper copy of the report from the UND Police Department located at 3851 Campus Road, Grand Forks, ND, 58202.</p></div></div></div></div></div></div></div></div></div></div></div>

Chronic Care Nurse

Cahaba Medical Care Foundation

<div><div><b>Chronic Care Management Nurse/RN</b></div><div></div><div><i><br>
Reports to </i><b><i>Chief Quality Officer</i></b></div><div><b><br>
 Cahaba Medical Care Foundation</b></div><p><b>
 Supervised by: </b>Chief Quality Officer</p><h3 class="jobSectionHeader">
Position Overview:</h3><p>
The Chronic Care Management Nurse plays a pivotal role in providing personalized care for patients with chronic conditions, including but not limited to diabetes, hypertension, asthma, COPD, heart disease, and other long-term illnesses. This role involves monitoring patients' health status, educating them on their conditions, ensuring adherence to treatment plans, and promoting proactive measures to prevent complications. The Chronic Care Management Nurse collaborates closely with physicians, care teams, and patients to deliver high-quality care in a clinic setting.</p><h3 class="jobSectionHeader">
Working Environment:</h3><ul><li><p>
Clinic Hours: Monday to Friday, 8:00 AM &ndash; 5:00 PM (with occasional extended hours depending on patient needs).</p></li><li><div>
Environment: Fast-paced, team-oriented, and patient-focused clinic setting.</div></li><li><p>
Physical Demands: Standing, walking, and sitting for extended periods. Occasional lifting of patients or equipment may be required.</p></li></ul><h3 class="jobSectionHeader">
Key Responsibilities:</h3><h4 class="jobSectionHeader">
Patient Care &amp; Management:</h4><ul><li><p>
Chronic Disease Management:</p><ul><li><div><br>
Monitor and assess the health status of patients with chronic conditions, including vital signs, lab results, medications, and treatment adherence.</div></li><li><div>
Provide ongoing education and support to patients on managing their chronic conditions and improving health outcomes.</div></li><li><div>
Collaborate with physicians and other healthcare providers to develop and implement personalized care plans based on patient needs.</div></li><li><div>
Offer routine assessments for patients in both in-person and remote settings, such as phone calls or telehealth visits.</div></li></ul></li><li><div>
Medication Management:</div><ul><li><div><br>
Educate patients on the proper use of prescribed medications and monitor for adherence, side effects, and potential drug interactions.</div></li><li><div>
Coordinate medication refills and communicate with pharmacies/providers as necessary.</div></li><li><div>
Assist in adjusting medication regimens as ordered by the physician, in accordance with established protocols.</div></li></ul></li><li><div>
Care Coordination:</div><ul><li><div><br>
Act as a point of contact for patients with chronic conditions, ensuring that all aspects of care are coordinated, including referrals, tests, and specialist visits.</div></li><li><div>
Communicate and follow up with patients to ensure continuity of care and address any issues or concerns promptly.</div></li><li><p>
Monitor patients' progress and identify early signs of complications or deterioration in their condition.</p></li></ul></li></ul><h4 class="jobSectionHeader">
Education &amp; Support:</h4><ul><li><p>
Patient Education:</p><ul><li><div><br>
Provide education on managing chronic diseases, including self-management skills, lifestyle changes, diet, exercise, and coping strategies.</div></li><li><div>
Educate patients and their families on the importance of preventative care, such as routine screenings, immunizations, and other health-related behaviors.</div></li><li><div>
Use self management methods to ensure patients understand their treatment plans and health goals.</div></li></ul></li><li><div>
Health Promotion:</div><ul><li><div><br>
Help patients set realistic, measurable goals to improve their health and quality of life.</div></li><li><div>
Guide patients through disease-specific management strategies, including symptom monitoring, tracking triggers, and recognizing warning signs.</div></li><li><p>
Empower patients to take ownership of their health and become active participants in their care plans.</p></li></ul></li></ul><h4 class="jobSectionHeader">
Documentation &amp; Reporting:</h4><ul><li><p>
Patient Records:</p><ul><li><div><br>
Maintain accurate and up-to-date patient records in compliance with clinic policies and relevant regulations (e.g., HIPAA).</div></li><li><div>
Document patient assessments, care plans, interventions, progress notes, and any changes in condition or treatment in the electronic health record (EHR).</div></li><li><p>
Complete required reports related to chronic care management programs, including billing and outcome documentation.</p></li></ul></li></ul><h4 class="jobSectionHeader"><br>
Quality Improvement:</h4><ul><li><p>
Outcomes Monitoring:</p><ul><li><div><br>
Track and report on the effectiveness of chronic care management services, identifying areas for improvement in care delivery.</div></li><li><div>
Participate in quality improvement initiatives aimed at improving patient outcomes and enhancing the overall care process.</div></li><li><p>
Support the clinic&rsquo;s efforts to meet accreditation standards, quality measures, and performance benchmarks for chronic care management.</p></li></ul></li></ul><h3 class="jobSectionHeader">
Skills and Qualifications:</h3><ul><li><p>
Education and Certification:</p><ul><li><div><br>
Registered Nurse (RN) or Licensed Practical Nurse (LPN)with an active state license.</div></li><li><div>
BLS (Basic Life Support) certification</div></li></ul></li><li><div>
Experience:</div><ul><li><div><br>
Minimum of 2-3 years of nursing experience, with a focus on chronic disease management, geriatrics, or related areas.</div></li><li><div>
Experience working in a clinic or outpatient setting preferred.</div></li><li><div>
Knowledge and experience in patient education, health promotion, and care coordination.</div></li></ul></li><li><div>
Technical Skills:</div><ul><li><div><br>
Proficiency with Electronic Health Records (EHR) systems.</div></li><li><div>
Basic knowledge of chronic care management programs and healthcare regulations.</div></li><li><div>
Familiarity with telemedicine platforms and remote patient monitoring is a plus.</div></li></ul></li><li><div>
Interpersonal Skills:</div><ul><li><div><br>
Excellent communication skills, both verbal and written, to effectively interact with patients, families, and healthcare professionals.</div></li><li><div>
Ability to work collaboratively within a multidisciplinary team.</div></li><li><div>
Strong critical thinking and problem-solving skills, with the ability to assess complex situations and make sound clinical decisions.</div></li></ul></li><li><div>
Personal Attributes:</div><ul><li><div><br>
Empathy and compassion for patients with chronic conditions.</div></li><li><div>
Strong organizational skills and attention to detail.</div></li><li><div>
Ability to manage a high volume of patients and prioritize care effectively.</div></li></ul></li></ul><h3 class="jobSectionHeader">
Additional Information:</h3><p>
The Chronic Care Management Nurse is a critical member of our care team, dedicated to improving the health and quality of life of patients with chronic conditions. This role provides an opportunity to make a meaningful difference in the lives of patients, empowering them to manage their health and prevent complications associated with chronic diseases.</p></div>

Chronic Care Management Nurse

Hoss Care

<div>
 <strong>
  Company Description
  <br/>
 </strong>
 <p>
  Hoss Care leverages an AI-powered remote care platform to deliver continuous, HIPAA-compliant monitoring and chronic care management. Trusted by leading health systems, Hoss Care integrates FDA-approved devices, predictive analytics, and automated care coordination. The platform is designed to enhance clinical outcomes, improve medication adherence, and reduce hospitalizations. Hoss Care is committed to transforming healthcare delivery and supporting providers in delivering exceptional patient care.
  <br/>
 </p>
 <strong>
  Role Description
  <br/>
 </strong>
 <p>
  This is a full-time, on-site Nurse position located in Miami, FL. The Nurse will provide direct patient care, coordinate and monitor treatment plans, and ensure compliance with healthcare protocols. The role includes utilizing patient data and predictive analytics tools to assess and respond to health needs, collaborating with interdisciplinary teams, educating patients on medication adherence, and supporting chronic disease management. Exceptional communication and a compassionate approach to patient care are essential.
  <br/>
 </p>
 <strong>
  Qualifications
  <br/>
 </strong>
 <ul>
  <li>
   Proficiency in patient care, including administering treatments, managing medications, and monitoring patient status
  </li>
  <li>
   Strong skills in care coordination, chronic disease management, and patient education
  </li>
  <li>
   Experience using digital health tools, electronic health records (EHR), and familiarity with predictive analytics
  </li>
  <li>
   Excellent interpersonal, communication, and collaborative skills for working within interdisciplinary teams
  </li>
  <li>
   Current Registered Nurse (RN) license in Florida
  </li>
  <li>
   BLS/ACLS certification preferred
  </li>
  <li>
   Experience in chronic care, remote patient monitoring, or telehealth services is a plus
  </li>
 </ul>
</div>


Nurse

Advanced Monitored Caregiving

<div><p>At AMC Health, we are transforming healthcare through advanced remote patient monitoring and virtual care solutions that help patients manage chronic conditions safely at home. Our care teams play a critical role in improving outcomes, enhancing patient engagement, and reducing avoidable hospitalizations.</p>
<p>We are seeking a <b>Telephonic Nurse Care Associate (LPN/LVN)</b> who is passionate about patient engagement, chronic care support, and using technology to improve healthcare delivery.</p>
<p></p><p><b>What You&rsquo;ll Do</b></p>
<ul><li>Conduct telephonic clinical outreach to patients enrolled in Remote Patient Monitoring (RPM) and chronic care programs.</li>
<li>Review biometric alerts and identify out-of-range readings; escalate clinical concerns according to protocols.</li>
<li>Provide patient education and coaching to support adherence to care plans and lifestyle recommendations.</li>
<li>Accurately document patient encounters in EMR/RPM systems in compliance with clinical and regulatory standards.</li>
<li>Collaborate with clinical management, RN Care Managers, providers, and interdisciplinary care teams to coordinate patient care.</li>
<li>Support patient engagement initiatives designed to improve monitoring compliance and clinical outcomes.</li>
</ul>
<p></p><p><b>What You Bring</b></p>
<ul><li>Active <b>LPN/LVN license</b> in good standing.</li>
<li><b>5+ years of clinical experience</b>, including <b>3+ years</b> in care coordination, telehealth, home care, or chronic disease management.</li>
<li>Experience supporting patients with conditions such as CHF, COPD, diabetes, or hypertension preferred.</li>
<li>Strong telephonic communication, patient education, and motivational interviewing skills.</li>
<li>Experience using EMR/EHR systems and comfort working in a technology-enabled care environment.</li>
<li>Ability to work independently in a structured remote clinical workflow.</li>
</ul>
<p><b>Why AMC Health</b></p>
<ul><li>Fully remote clinical role supporting patients nationwide</li>
<li>Opportunity to work at the forefront of virtual care innovation</li>
<li>Collaborative interdisciplinary care teams</li>
<li>Meaningful work improving patient outcomes every day</li>
<li>Growth opportunities within expanding virtual care programs</li>
</ul>
<p><b>Work Environment Requirements</b></p>
<ul><li>Private, secure, distraction-free home workspace</li>
<li>Reliable high-speed internet connectivity</li>
<li>Ability to work schedules aligned with assigned patient populations or client time zones</li></ul></div>

Telephonic Nurse Care Associate

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