Registered Nurse (RN) - Remote

Pine Park Health is a value-based primary care practice revolutionizing healthcare for senior living community residents. We empower seniors to get healthy, stay healthy, and lead lives they love through a care model designed with everyone in mind — patients, families, community staff, providers, and payers. Our approach brings healthcare directly to seniors' homes, offering prevention, screening, chronic condition management, lab work, and diagnostic testing in the comfort of their apartments. With weekly community visits, our teams provide consistent care while collaborating closely with facility staff to address comprehensive health needs. We've eliminated unnecessary barriers to urgent care through same/next-day appointments, helping seniors avoid emergency rooms and hospitalizations where they risk exposure to additional health concerns. Today, over 185+ communities across Arizona, California, and Nevada trust Pine Park Health, and we're rapidly expanding our reach and impact. If you're mission-driven and passionate about transforming senior healthcare, this is your opportunity to make a meaningful difference!

The Registered Nurse is responsible for the management and coordination of patient care in collaboration with the primary care provider. The nurse acts as a triage nurse, educator, facilitator and patient advocate.

Functions as a member of the Interdisciplinary Team (IDT) to coordinate patient care to promote positive health outcomes. Is responsible to clinically triage all phone calls from providers, patients, caregivers and other outside agencies. Coordinates services with insurance system and the community for benefits to promote the most appropriate disposition of the patient to meet the needs of the patient, family and insurance company when able. Daily review of lab and diagnostic test results, reviews with providers and contacts patient or the responsible party with results and reviews plan of care. Daily tasks: medication and lab orders, admit to SNF, DME, follow up on the status of orders/diagnostics, controlled and non-controlled refills, chart audit and preparation for Providers, patient and family phones calls, specialist referrals, document preparation, prior authorizations Provides daily Chronic Care Management for all eligible PPH patients and documents all CCM time. Develops, implements and monitors Chronic Care Management Patient Centered Care Plans. Provides Transitional Care for all PPH patients discharged from one level of care to another (acute care, skilled care, live discharge from hospice) Coordinates care with the following: acute care case management, ER's, skilled nursing facilities, discharge planners, home health, hospice, EMS Participates in overall program development and adherence to policies, procedures, processes, state and federal regulations. Acts as a resource to internal and external customers. Assists with other duties as assigned.