Nurse Care Manager

Position Title : Nurse Care Manager

Reports To : Director of Quality

FLSA Status : Full time - Salaried, exempt as defined under Fair Labor Standards Act

Location : Airport

Content Last Revised : 10 / 09 / 2025

Organization Overview

The Central Florida Family Health Center, Inc. dba True Health is a private, not-for-profit federally qualified health center (FQHC) serving Central Florida since 1977. Our mission is to provide high-quality, comprehensive healthcare at a reasonable cost to everyone.

Job Summary

The Nurse Care Manager is responsible for overseeing and coordinating all aspects of the Medication-Assisted Treatment (MAT) and HIV programs. This role ensures seamless integration of behavioral health and support services to improve patient outcomes. The Nurse Care Manager supports the care teams in the delivery of evidence-based treatment while ensuring compliance with federal, state, and grant regulations. This role blends clinical expertise with care coordination, patient education, and quality improvement. The Nurse Care Manager may also be assigned to work on select clinical projects to reduce health disparities and improve health outcomes and will be assigned to the MAT / HIV programs which may include grant coordination and adherence. This is NOT a remote position.

Key Responsibilities

• Maintains a transparent, effective relationship with the Director of Quality by supporting the organization's activities
• Fosters an environment and culture that focuses on fulfilling the company's mission, vision, and values
• Coordinate patient enrollment, intake, and follow-up within the MAT and HIV programs
• Ensure patients receive timely access to medications, counseling, and support services
• Maintain scheduling, communication, and coordination between care teams
• Track outcomes, including retention, relapse prevention, and quality metrics
• Identify barriers to treatment and work to improve access and continuity of care
• Facilitate staff education on subjects such as MAT workflows, patient engagement, and evidence-based practices
• Travel between True Health sites as needed for delivery of supplies and / or staff education in addition to meeting patients face-to-face as needed
• Develop, implement, and update individual care plans in collaboration with patients, families, and providers using the electronic health record
• Lead and / or participate in quality improvement projects and risk / compliance activities
• Maintain patient confidentiality and comply with HIPAA and organizational policies
• Connect patients to relevant community resources as required, with the goal to increase satisfaction, patient health, and well-being and reduce healthcare costs
• Act as a liaison between patients, referring providers, or outside agencies to coordinate patient appointments.
• Coordinate the exchange of information either written or verbal before and after patients are seen
• Address patients and family members with concern and empathy
• Perform patient outreach and schedule appointments as needed
• Assist with data mining and research initiatives
• Answer phone calls and return messages in a timely manner
• Monitor the inbox within the electronic health record and send patient letters / correspondence timely
• Assist with tracking of referrals as necessary, ensuring documentation is current with necessary updates from patients and referral providers
• Develop, implement, and update individual care plans in collaboration with patients, families, and providers
• Provide disease management education along with preventative care management, health coaching, and motivational interviewing to support patient self-management and include patient families, other members of the healthcare team, etc.
• Monitor patient progress, track outcomes, and document interventions in the electronic health record (EHR) and excel spreadsheets as applicable
• Attend and participate in workgroups, program meetings, and other associated events as appropriate
• Advocate for patients by addressing barriers such as transportation, financial needs, and access to medication or community resources
• Provide direct patient education during clinic visits, in the patient portal, and through outreach calls
• Work collaboratively with other members of the healthcare team in coordination of the patient's care
• Participate in development activities and maintains professional affiliations
• Foster and develop partnerships to further the mission of the organization
• Travel as necessary using personal vehicle (must maintain current auto insurance at own expense)
• Other responsibilities as assigned

Essential Functions

Minimum Qualifications

Prohibited criminal behavior is defined in Florida Statute (F.S.) 408.809. Any employee arrested for any offense outlined in the F.S.408.809 will be immediately suspended and remain suspended until the charges are disposed of in court. The employee will be terminated for an arrest or conviction of any violation listed above.

DRUG / ALCOHOL SCREENINGS

A post-offer drug and alcohol screen is a requirement for employment. Failure to successfully pass the drug / alcohol screen will be cause for the offer to be rescinded. Employees are subject to random drug / alcohol screenings throughout the duration of their employment with True Health. If an employee fails to pass the drug / alcohol screening, then this shall become grounds for discipline up to and including immediate termination.

WORK ENVIRONMENT

WORKING CONDITIONS

The employee will work as the needs of the operation require. Normal work days and hours are Monday through Thursday, 8am - 6pm and Fridays, 8am - 12pm; however, there will be times when the employee will need to come in or work on "off hours" or "off days" to meet the needs of the position.