Carolina Health Centers, Inc.
Lead Care Manager
– This role coordinates and delivers care management services to patients with multiple chronic conditions. Focused on building trusting relationships, developing individualized plans, and collaborating with care teams to improve outcomes while reducing avoidable hospitalizations. The lead also mentors new care managers, supports onboarding, resolves operational issues, and covers for the CCM Coordinator.
Responsibilities
Provide monthly care management services for assigned patients in accordance with CMS guidelines.
Perform comprehensive patient assessments (medical, social, functional, behavioral health).
Develop, implement, and update patient‑centered care plans with input from patients, families, and providers.
Conduct monthly billable check‑ins, track time, and ensure accurate documentation in the EHR.
Coordinate care across providers, specialists, hospitals, and community resources.
Support Remote Patient Monitoring initiatives by reviewing data, identifying trends, and intervening as needed.
Provide health coaching and education related to chronic disease management.
Monitor and address gaps, preventative screenings, and medication adherence.
Escalate high‑risk patients to provider review.
Participate in quality improvement initiatives for care management and population health.
Offer mentorship and training to newly hired care managers.
Serve as point of contact and provide coverage during CCM Coordinator’s absence.
Provide operational support during program startup and observe workflows for strategic input.
Reporting Relationships Directly supervised by the Chronic Care Management Coordinator.
No workers supervised.
Qualifications
Bachelor of Science in Nursing from an accredited School of Nursing.
Current, unrestricted nursing license in South Carolina or a compact state.
Minimum two years of nursing experience, preferably in primary care, care management, case management, or chronic disease management.
Excellent written and oral communication skills.
Proficiency in computer use and keyboards, along with electronic health record (EPIC preferred).
Strong interpersonal skills and ability to build rapport remotely.
Ability to work independently, manage time effectively, and prioritize patient needs.
Knowledge of CMS billing guidelines and documentation standards for care management programs.
Experience with telehealth, remote patient monitoring, or population health programs.
Manual dexterity to operate computer, phone, copier, and standard office equipment.
Sound hearing and vision, including color, peripheral, depth and close/distance vision.
Reliable internet access and a private, HIPAA‑compliant remote work environment; occasional travel to clinics, training or community events may be required.
All employees of Carolina Health Centers, Inc. are expected to perform the duties of their job and behave in a manner consistent with the Corporate Philosophy which supports the values of honesty, integrity, openness, the pursuit of individual and collective excellence, and unwavering mutual respect and appreciation.
Location: Remote/Greenwood, SC. Salary range: $5,863.20 – $6,438.20 per month.
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– This role coordinates and delivers care management services to patients with multiple chronic conditions. Focused on building trusting relationships, developing individualized plans, and collaborating with care teams to improve outcomes while reducing avoidable hospitalizations. The lead also mentors new care managers, supports onboarding, resolves operational issues, and covers for the CCM Coordinator.
Responsibilities
Provide monthly care management services for assigned patients in accordance with CMS guidelines.
Perform comprehensive patient assessments (medical, social, functional, behavioral health).
Develop, implement, and update patient‑centered care plans with input from patients, families, and providers.
Conduct monthly billable check‑ins, track time, and ensure accurate documentation in the EHR.
Coordinate care across providers, specialists, hospitals, and community resources.
Support Remote Patient Monitoring initiatives by reviewing data, identifying trends, and intervening as needed.
Provide health coaching and education related to chronic disease management.
Monitor and address gaps, preventative screenings, and medication adherence.
Escalate high‑risk patients to provider review.
Participate in quality improvement initiatives for care management and population health.
Offer mentorship and training to newly hired care managers.
Serve as point of contact and provide coverage during CCM Coordinator’s absence.
Provide operational support during program startup and observe workflows for strategic input.
Reporting Relationships Directly supervised by the Chronic Care Management Coordinator.
No workers supervised.
Qualifications
Bachelor of Science in Nursing from an accredited School of Nursing.
Current, unrestricted nursing license in South Carolina or a compact state.
Minimum two years of nursing experience, preferably in primary care, care management, case management, or chronic disease management.
Excellent written and oral communication skills.
Proficiency in computer use and keyboards, along with electronic health record (EPIC preferred).
Strong interpersonal skills and ability to build rapport remotely.
Ability to work independently, manage time effectively, and prioritize patient needs.
Knowledge of CMS billing guidelines and documentation standards for care management programs.
Experience with telehealth, remote patient monitoring, or population health programs.
Manual dexterity to operate computer, phone, copier, and standard office equipment.
Sound hearing and vision, including color, peripheral, depth and close/distance vision.
Reliable internet access and a private, HIPAA‑compliant remote work environment; occasional travel to clinics, training or community events may be required.
All employees of Carolina Health Centers, Inc. are expected to perform the duties of their job and behave in a manner consistent with the Corporate Philosophy which supports the values of honesty, integrity, openness, the pursuit of individual and collective excellence, and unwavering mutual respect and appreciation.
Location: Remote/Greenwood, SC. Salary range: $5,863.20 – $6,438.20 per month.
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