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Chronic Care Management Nurse

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Job Description - Chronic Care Management Nurse

Chronic Care Management (CCM) Nurse


Health Ministries Clinic (HMC) is seeking a compassionate and detail-oriented Chronic Care Management (CCM) Nurse to join our integrated care team in Newton, Kansas. This is a full-time position offering the opportunity to support patients with ongoing health needs in a collaborative, mission-driven environment.


As a key member of our care team at a Federally Qualified Health Center (FQHC), the CCM Nurse plays an essential role in coordinating care for patients with chronic conditions. In this role, you will work closely with providers and patients to develop care plans, monitor health progress, and ensure patients receive the resources and support they need to manage their health effectively.


What You'll Do


Care Coordination



  • Identify and enroll eligible patients in the Chronic Care Management program.

  • Develop and maintain individualized care plans for patients with chronic conditions.

  • Coordinate care between providers, specialists, pharmacies, and community resources.


Patient Outreach & Support



  • Conduct regular patient outreach via phone or electronic communication to monitor health status and care needs.

  • Provide education on chronic disease management, medications, and healthy lifestyle practices.

  • Assist patients in accessing community resources and support services.


Documentation & Compliance



  • Document all patient interactions and care coordination activities in the Electronic Health Record (EHR).

  • Track and record time spent on CCM services in accordance with program and billing requirements.

  • Maintain compliance with HIPAA and confidentiality standards.


Qualifications



  • Associate or bachelor's degree in nursing required.

  • Current Kansas Registered Nurse (RN) license required.

  • Strong communication, organization, and patient education skills.

  • Ability to manage multiple tasks and maintain accurate documentation.


Why Work at HMC?



  • Make a Real Impact: Your work helps patients better manage chronic conditions and improve long-term health outcomes.

  • Team-Based Care: Work within an integrated primary care and behavioral health model.

  • Work-Life Balance: Enjoy a stable weekday schedule in a mission-driven organization.


What We Offer



  • Set weekday schedule

  • Medical, dental, and vision insurance

  • Retirement plan with employer contributions

  • Supportive team environment with dedicated clinical and administrative staff


About Health Ministries Clinic


Health Ministries Clinic is a mission-focused Community Health Center committed to serving all patients-regardless of ability to pay. Our three main service lines include Medical, Behavioral Health, and Dental, along with extensive ancillary and assistive services that allow our clinicians and support staff to provide comprehensive care.


Apply Today


Join a close-knit, compassionate team delivering high-quality care in a supportive environment. Apply now and help shape a healthier future for our community.



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