Spanish Speaking - Nurse / Nurse Practitioner for Chronic Care Management (CCM)

Position: Spanish Speaking Nurse or Nurse Practitioner
Location: 100% remote
**Employment Type: Full-time/ part-time/ contractor

Overview
We are seeking a dedicated and compassionate Chronic Care Management (CCM) Nurse or Nurse Practitioner to join our care team. This role is essential in supporting patients with multiple chronic conditions through proactive care coordination, patient education, and continuous monitoring. The CCM Nurse/NP will serve as the patient’s advocate, working closely with physicians, specialists, and family members to improve health outcomes and enhance quality of life.

Key Responsibilities
Deliver comprehensive, patient-centered chronic care management services in alignment with CMS guidelines.

Conduct telephonic assessments to monitor symptoms, medication adherence, lifestyle factors, and care needs.

Develop, implement, and update personalized care plans in collaboration with patients, families, and healthcare providers.

Provide ongoing education and counseling to patients regarding disease management, treatment plans, medications, and self-care strategies.

Identify and address barriers to care, including social determinants of health, access to resources, and patient engagement.

Coordinate with physicians, specialists, and other care team members to ensure timely follow-up and continuity of care.

Document all patient interactions and care activities in the electronic health record (EHR) in compliance with regulatory standards.

Track and report patient progress, clinical outcomes, and program effectiveness.

Support quality improvement initiatives and participate in staff training as needed.

Qualifications
Required:

Current RN or NP license

Spanish speaking

Strong clinical background in managing chronic diseases (e.g., diabetes, hypertension, COPD, CHF).

Excellent communication, care coordination, and patient engagement skills.

Proficiency in electronic health records and care management platforms.

Ability to work independently and as part of a multidisciplinary team.

Preferred:

Bilingual skills

Key Competencies
Patient-centered, empathetic, and resourceful approach to care

Strong organizational and time-management skills

Critical thinking and problem-solving abilities

Commitment to quality improvement and best practices

Benefits
Flexible schedule (remote options available)

Opportunities for professional development and continuing education

Collaborative and supportive team environment