RN Cardiology/Chronic Case Management Remote Position- Orlando FL

• Provide comprehensive care management for cardiology patients, including vascular, EP, general cardiology, the Heart Failure program and Transitional Care Management program.
• Work with a health coach to develop, implement, and monitor personalized care plans that address patient needs, including medication management, lifestyle modifications, and symptom management.
• Conduct remote patient assessments to evaluate health status, identify care gaps, SDOH, and comprehensive, holistic chronic care needs.
• Respond to patients' clinical changes by performing a comprehensive assessment, updating medication regimens, implementing remote patient monitoring protocols, and making necessary adjustments to treatment plans to ensure optimal patient outcomes.
• Working closely with the clinical team and providers, ensure that interventions, care coordination, and closed communication are delivered and address patients’ needs.
• Educate patients and their caregivers on disease management and prevention of hospital admissions, emphasizing adherence to care plans, preventive care strategies, risk reduction.
• Deliver comprehensive transitional care management, ensuring continuity of care, reducing readmissions, ensuring timely visits, and completing medication reconciliation.
• Provide clinical leadership to a team of clinical staff to deliver high-quality patient-centered and appropriate care. Ensure team adherence to clinical protocols, best practices and regulatory requirements.
• Collaborate with interdisciplinary teams, including cardiologists, primary care providers, APPs, social workers, care coordinators, to align care delivery across the continuum.
• Maintain accurate and timely documentation in electronic health record (EHR) systems, and care management platforms, adhering to organizational and regulatory standards.
• Ensure compliance with HIPAA, CMS guidelines, and other healthcare regulations

• Graduate from an accredited school of nursing. BSN preferred.
• Current and unrestricted Florida State license & registration in the Florida Board of Nursing
• Minimum of 3 years of clinical experience.
• Cardiology or Chronic Care Management experience required.
• Demonstrated leadership or supervisory experience -team leading experience a plus

• Strong computer skills are required as different programs, applications and websites will be utilized.
• Strong organizational, time management and interpersonal skills, with the ability to manage multiple priorities.
• Adherence to all policies and procedures, including but not limited to standards for safety, attendance, punctuality, and professionalism.
• Proficiency in working with electronic health records, such as Athena, NextGen, as well as Microsoft Word, and Excel is preferred. 
• Bilingual in English and Spanish is PLUS.
• This position is remote basedmust reside near Orlando, Florida. A dedicated space to ensure patient privacy with reliable broadband is required.  

  To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.  

• 401(k) 
• Health insurance 
• Dental insurance 
• Vision insurance 
• Disability insurance 
• Life insurance 
• Paid time off 

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