Clinical Care RN

Jaan Health is seeking a dynamic and motivated Clinical Care RN to join our care team and will report to the Clinical Operations Manager. This role requires strong clinical knowledge, adaptability, and the ability to thrive in a fast-paced, patient-centered environment. The Clinical Care Lead will support chronic care management (CCM) and advanced primary care models (APCM) by providing direct patient engagement, care plan support, and clinical triage. This position is remote and offers health benefits as well as a retirement plan and paid days off.

We are seeking a compassionate, organized, and tech-savvy Clinical Care Lead to support patients with chronic conditions in our text-based Advanced Primary Care Management (APCM) program. This remote role focuses on delivering proactive, high-quality care through digital communication tools, driving better health outcomes for Medicare and older adult populations.

This position is ideal for healthcare professionals who thrive in a virtual care setting, value patient engagement, and are skilled in critical thinking and care coordination.

• →Serve as the first line of communication for patients via a secure, text-based platform
• →Monitor and respond to patient messages and check-ins in a timely, compassionate, and professional manner
• →Identify, assess, and triage clinical concerns, SDOH needs, and care coordination barriers
• →Develop and update personalized care plans for patients with chronic conditions (e.g., hypertension, diabetes, COPD)
• →Develop, implement, and revise care coordination workflows or protocols to support the evolution of the care model to improve efficiency and scalability
• →Analyze patient data or trends to identify care gaps or improve outcomes
• →Independently making decisions on patient outreach priorities, resource allocation, or escalation paths
• →Lead quality improvement initiatives or case review meetings
• →Serve as a liaison for payer utilization management, interpreting policy, and advising on compliance
• →Track engagement, log care time, and document all communication per HIPAA and program guidelines
• →Identify and troubleshoot issues that arise during new program iterations, escalating to leadership when there are critical impacts or opportunities for system-wide improvements
• →Collaborate with RNs, NPs, and Social Workers to ensure timely escalation and follow-through
  
  

• 4+ years of experience in a clinical or care coordination role (primary care, chronic care management, home health, etc.), or 2+ years experience combined with  with a BSN degree
• RNs w/ current license 
• Strong critical thinking and problem-solving skills in a fast-paced environment
• Ability to independently manage a digital patient panel and prioritize escalations effectively
• Excellent written communication and documentation skills
• Comfort using EMRs, care coordination platforms, and digital messaging tools
• Knowledge of Medicare CCM/APCM programs a plus
• Bilingual (Spanish) is a bonus but not required
• Must be located within the New Lenox, IL area and have access to reliable internet 
• Access to Internet 5G

• Full-time, Monday–Friday from 8:30am-5pm
• 1-hour lunch break, daily huddles with manager/team
• Ongoing support from a multidisciplinary care team

Phamily is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other legally protected status.