Registered Nurse of Complex Care Coordination
Role Overview
The Complex Care Coordination RN is a hybrid registered nurse, based out of Monticello, NY, who supports the coordination and delivery of timely, appropriate, and cost-effective care for patients across multiple HV sites.
The RN partners with on-site clinical teams to provide telephonic triage, chronic disease management support, and coordination of timely follow-up for patients.
The Complex Care Coordination RN uses evidence-based protocols to assess symptoms, escalate red-flag findings, close care gaps, and reinforce self-management education, extending nursing capacity to sites without dedicated care-coordination staff on-site.
The position is accountable for outcomes that matter in value-based arrangements, health center access metrics, and for the quality, safety, and documentation of every clinical encounter.
Key Skills for This Role
Full Job Posting
Qualifications
- Current, unencumbered Registered Nurse (RN) license in the State of New York.
- BSN preferred; ADN considered
- Care coordination, care management, transitions of care, or telehealth/triage experience strongly preferred.
- Experience with chronic disease management (CHF, diabetes, hypertension) and evidence-based patient education.
- Proficiency with electronic health records and standard office productivity tools; comfort with telehealth technology and secure remote communication.
- Strong clinical assessment, critical thinking, and prioritization skills in a remote, high-volume environment.
- Excellent verbal and written communication skills; ability to build rapport with patients and cross-site teams in person, by phone, and video.
- Cultural humility and experience serving diverse, underserved, and rural communities preferred.
- Bilingual (English/Spanish) preferred.
- CPR/BLS certification current.
- Salary Range: $45.45-$55.15/hour
Responsibilities
- Relation to Mission The mission of Sun River Health is to increase access to comprehensive primary and preventive health care and to improve the health status of our community, especially for the underserved and vulnerable. Equal Employment Opportunity Sun River Health provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, sexual preference, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function. Americans with Disabilities Act Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law. Job Responsibilities The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the essential functions of the job and should not be considered as a detailed description of all the work requirements of the position. Sun River Health may change the specific job duties with or without prior notice based on the needs of the organization.
- Relation to Mission
- The mission of Sun River Health is to increase access to comprehensive primary and preventive health care and to improve the health status of our community, especially for the underserved and vulnerable.
- Equal Employment Opportunity
- Sun River Health provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, sexual preference, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.
- Americans with Disabilities Act
- Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.
- The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the essential functions of the job and should not be considered as a detailed description of all the work requirements of the position. Sun River Health may change the specific job duties with or without prior notice based on the needs of the organization.
Preferred Qualifications
- BSN preferred; ADN considered
- Care coordination, care management, transitions of care, or telehealth/triage experience strongly preferred.
- Cultural humility and experience serving diverse, underserved, and rural communities preferred.
- Bilingual (English/Spanish) preferred.
About Sun River Health
Providing comprehensive primary and preventive healthcare for all.
Visit company websiteJobs and hiring trendsApply for this job in 1 click
Skip the repetitive application forms
Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.
Trusted by over 500,000 job seekers on Base Career
More from this employer
More jobs at Sun River Health
A31 Psychotherapist (LMSW, LMHC, LCSW) - Fountain House (The Sydney Baer) (Part-Time)
New York City, USA
A31 Psychotherapist (LMSW, LMHC, LCSW) - Fountain House (The Sydney Baer) (Part-Time)
New York City, USA
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Queens, NY)
Jamaica, USA
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Queens, NY)
Jamaica, USA
Sun River Health provides the highest quality of comprehensive primary, preventative, and behavioral health services to all who seek it, regardless of insurance status and ability to pay, especially for the underserved a
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Hudson Valley)
Poughkeepsie, USA
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Hudson Valley)
Poughkeepsie, USA
A31 Psychotherapist (LMSW, LMHC, LCSW) - Fountain House (The Sydney Baer) (Part-Time)
New York City, USA
A31 Psychotherapist (LMSW, LMHC, LCSW) - Fountain House (The Sydney Baer) (Part-Time)
New York City, USA
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Queens, NY)
Jamaica, USA
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Queens, NY)
Jamaica, USA
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Hudson Valley)
Poughkeepsie, USA
Certified Midwife
Peekskill, USA
MAT Registered Nurse (RN) Care Manager - Substance Abuse (Hudson Valley)
Poughkeepsie, USA
Certified Midwife
Peekskill, USA