As an RN Care Manager (Medical Mutual), you will provide evidence-based Care Transitions Interventions to eligible members in Hamilton County using the nationally recognized Coleman Model. Through bedside visits, post-discharge home visits, and follow-up health coaching calls, you’ll reduce avoidable readmissions, strengthen patient self-management, and ensure safer recoveries at home.
This is nursing focused on prevention, education, and advocacy with time to think critically and connect meaningfully.
What You’ll Do
Clinical Care Coordination & Patient Advocacy
- Conduct bedside hospital visits, post-discharge home visits, and follow-up telephonic coaching
- Use RN clinical judgment to assess post-discharge risks and intervene early
- Collaborate with PCPs, hospitals, and care teams to ensure continuity of care
- Connect members to community-based services and health plan benefits addressing social determinants of health
- Promote patient confidence, safety, and independence at home
- Apply the four pillars of transitional care:Medication reconciliation
- Timely follow-up with primary care providers
- Use of a personal health record
- Early identification of red flag symptoms
Documentation & Compliance
- Complete and submit case summaries and physician summaries per program expectations
- Document all interventions in Client Track in accordance with COA and Medical Mutual standards
- Maintain HIPAA compliance and confidentiality at all times
- Complete follow-ups, reporting, and program activities as assigned
Qualifications
- Minimum 1 year of experience in home health, geriatrics, care management, population health, transitional care, or related setting
- Strong understanding of healthcare delivery systems, sites of care, and interdisciplinary roles
- Experience with electronic health records and virtual documentation
- Demonstrated ability to apply evidence-based practices and clinical judgment independently
- Strong critical thinking, organization, and time management skills
- High level of comfort working across multiple software systems
- Knowledge of community resources in Southwestern Ohio preferred
- Valid driver’s license and reliable transportation for in-home visits
Why RNs Choose COA
- Clinical autonomy without hospital shifts, nights, or weekends
- Time to educate, assess, and intervene proactively, not reactively
- 50+ years of trusted service supporting older adults
- High employee satisfaction in mission alignment and leadership trust
- Flexibility to manage your caseload and schedule
Benefits That Support Your Life and Purpose
- Flexible, friendly schedule - no holidays or overnights
- Pension plan with 6% annual company contribution for long-term security
- Generous paid time off and 12 paid holidays to recharge and stay well
- Medical, dental, and vision insurance for your health and peace of mind
- Professional development opportunities in care management and population health
- Pet insurance and Employee Assistance Program supporting your whole life, not just your job