The Nurse Care Manager works with patients to develop and implement care plans based on patient goals,
preferences, and disease states to promote improved health outcomes and quality of life. This individual will
work as part of a system-wide team comprised of nurses, community health workers, and case managers. The
Nurse Care Manager connects patients with appropriate internal and resources and community resources,
facilitates referrals to appropriate care services, and supports patient self-management, and communicates
with other care team members to reduce barriers to improved health care outcomes. The Nurse Care Manager
serves as an integral member of the care team, assesses patients for risk of adverse health outcomes and
high utilization of acute care services, and monitors the impact of care management interventions.
We are a Federally Qualified Health Center (FQHC). Our model of integrated care provides services for all life cycles and addresses the complexity of medical and social/economic issues facing our patients and the residents in the communities served. Our range of services include Pediatrics, Ob-Gyn, Adult Health, Dental, HIV/AIDS Outreach and Primary Care, Case Management, Behavioral Health, Nutrition, Podiatry, Weight Management, Community Health Workers, and Care Coordination.
Our clinical team of multi-disciplinary professionals work in concert to ensure that patient care is thorough, complete, and fully understood by the patient. Our Patient Centered Medical Home (PCMH) Level III model of care ensures that patient care is delivered through care teams involving an integrated approach that requires a high level of care coordination. As a result, we are able to address gaps in care and address barriers to care.
