New York Registered Nurse Care Coach

This is a remote role. CircleLink Health is looking for passionate, tech savvy New York registered nurses to work remotely and serve patients enrolled in Medicare’s Chronic Care Management Program. In this part time role (requires about 20 to 25 hours per week, depending on caseload), an RN Care Coach will be assigned a group of patients that they will be following and calling each month. In these monthly calls the Care Coach will provide education, coordinate care, close preventive care gaps, and coach on strategies for self-management to keep patients 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 two 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 preventive care measures, i.e. annual well visits, vaccines, cancer screens, follow-up/specialist appointments, etc. • 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 New York RN license required. • Proficiency with EHRs (electronic health records) and web-based applications • 3 or more years' experience as a Registered Nurse • Immediate availability Preferred Education and Experience: • Case Management or Chronic Disease Management experience highly preferred • Certified Diabetes Educator desired but not required • Experience with Motivational Interviewing or other behavior change communication techniques is a plus! Scheduling and Other Requirements • Must have a STRONG internet-connected computer. Computer and internet speed tests will be required. • A minimum of 20 hours of day time 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 equipment, taxes and insurance. Compensation: Compensation is paid at the rate of $15.00 per initial clinical encounter per patient per month. A clinical encounter occurs after two criteria are met: a patient has a successful clinical call and the patient has 20 minutes or more of time in their chart timer. • Ex: If in one hour you called and spoke with 2 patients and spent 20 minutes with each of them, your pay for that hour would be $30.00 ($15.00/pt reached x 2). Pay Timing: Monthly via direct deposit, 40 days after the last day of the month of service. This is due to the time it takes Medicare to process reimbursements. All checks after the first will be deposited about 30 days after the last day of the month of service. About CircleLink Health: CircleLink Health is a company of passionate clinicians, technologists and businesspeople tackling the $600B problem of preventable chronic and post-acute complications. We’re building a world-class Care Management platform to enable providers while accelerating the shift to preventative care instead of status quo reactive care. Learn more about us here. Apply tot his job