Remote Registered Nurse Care Coach
CircleLink HealthJob Description
This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare’s Chronic Care Management Program. In this part time role (about 20-25 hrs. per week), an RN Care Coach will be assigned a group of patients that they will be following and calling each month. In these monthly calls you will provide education, coordinate care, close preventive care gaps, and coach on strategies for self-management to keep them out of the hospital.
This Role Requires Precision, Discipline, and Accountability
The Care Manager role is not a step back from bedside nursing — it’s a step into a more complex, structured, and performance-driven environment. To succeed, you must bring more than clinical knowledge:
✅ Excellent documentation skills — Your charting must be complete, timely, and accurate.
✅ Strong time management — Case tasks must be prioritized and closed on schedule.
✅ Ownership of outcomes — Each case is closely tracked for quality, compliance, and effectiveness.
Expectations are high, and performance is regularly reviewed. This is not a role where details can be missed or timelines pushed — we need professionals who take initiative, stay organized, and consistently deliver.
If you’re ready for a challenging, fast-paced environment where your work is held to high standards and makes a real difference, we encourage you to apply.
Key Responsibilities:
- Utilize our specialized care management software to call Medicare patients with 2 or more chronic conditions (Diabetes, CHF, Chronic Pain, COPD, etc.) on a monthly basis
- Build and maintain rapport with patients to help coach them to improved health through SMART goals and education on self-management strategies
- Implement and improve the Plan of Care by updating medications, appointments due, biometrics, symptoms, and interventions made
- Connect the patient with community resources as needed, including transportation, personal care needs, prescription/DME assistance, social services, etc.
- Conduct Transitional Care Management activities to high risk patients discharged from the hospital and the ER to reduce unnecessary readmissions.
- Close care gaps by encouraging and assisting with preventive care measures, i.e. annual well visits, vaccines, cancer screens, follow-up/specialist appointments, etc.
Requirements
- Fluent in English
- Self-directed, able to work independently with little supervision while meeting performance metrics
- Passion for nursing and improving patient outcomes
- Good with technology and eager to learn and use new software
- Excellent organizational and time management skills
- Strong communication and telephonic skills
- Strong critical thinking and problem-solving skills
Education and Experience:
- Current, unrestricted Compact License or an RN license in: Georgia, Indiana, North Carolina, or Maryland, USA
- Proficiency with electronic health records and web-based applications
- 3+ years' experience as a Registered Nurse
Preferred Education and Experience, but not required:
- Spanish fluency
- Case Management or Chronic Disease Management experience highly preferred
- Certified Diabetes Educator
- Experience with Motivational Interviewing or other behavior change communication techniques
Scheduling and Other Requirements
- RN needs a STRONG internet-connected computer
- Minimum of 20 hours of availability per week required
- You will commit to your own schedule using our software.
- This is a 1099 contract position with no end date. Care coaches are responsible for their own taxes and insurance.
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