Registered Nurse - Patient Care Coordinator (Hybrid, 1-2 days/week onsite)

Empowering communities through accessible, inclusive, and compassionate care, this is the work we do every day.

At Jane Pauley Community Health Center , every role is connected to something bigger. As a Federally Qualified Health Center (FQHC), we deliver integrated, whole-person care to individuals and families across Indiana, regardless of income or insurance status.

Our teams work at the intersection of clinical excellence and community impact, supporting underserved populations while building a culture rooted in collaboration, respect, and growth. Here, you are not just joining a workplace, you are becoming part of a mission that truly matters.

Must live within a reasonable distance of the Indianapolis area to commute to the office 1-2 days/week.

We are currently seeking a Patient Care Coordinator (RN) to join our team. This role is ideal for a registered nurse who is passionate about care coordination, patient advocacy, and driving quality improvement. The Patient Care Coordinator works closely with providers, staff, and external partners to ensure smooth care transitions, support chronic disease management, and improve patient outcomes.

Job Summary

The Patient Care Coordinator is an essential member of the practice care team, working under the direction of the Practice Manager. This role supports health promotion, disease prevention and management, patient education, nursing care planning, and coordination of care with both internal teams and external facilities. The position is hybrid-remote, with work arrangements tailored to the needs of the RN and JPCHC leadership.

Job Responsibilities (include but are not limited to):

Patient Advocacy & Care Coordination

Serve as a patient advocate, helping patients navigate the healthcare system

Provide patient education using evidence-based practice and JPCHC-approved resources

Support patient self-care management of disease and behavior modification interventions

Coordinate continuity of care between primary and specialty providers, hospitals, ERs, and JPCHC teams

Conduct telephonic outreach to patients post-hospitalization, discharge, or ER visit

Manage care transitions for high-risk patients, ensuring timely follow-up appointments

Perform phone triage, medication refills, and prior authorizations within scope of licensure

Document all patient interactions accurately and consistently in the EMR

Quality Improvement & Clinical Support

Participate in quality improvement (QI) initiatives and provide feedback on clinical best practices

Monitor closure of care gaps, quality metrics, overdue labs, and abnormal results

Perform proactive outreach to patients due for preventive screenings

Support pre-visit planning with providers and staff

Assist with data collection, outcomes reporting, clinical audits, and program evaluation related to Patient-Centered Medical Home (PCMH) and Medical Neighborhood initiatives

Preceptorship & Mentorship

Serve as a nurse preceptor for newly hired clinical staff or nursing students

Required Skills and Qualifications

Current state licensure as a Registered Nurse (RN) required

Graduation from an accredited nursing program required

Basic Life Support (BLS) certification through AHA required

Minimum 2 years’ experience in ambulatory, triage, or acute care setting preferred

2–5 years’ experience in chronic disease management, case management, utilization management, or adult acute care preferred

1 year of experience or knowledge of Patient-Centered Medical Home (PCMH) initiatives preferred

Strong critical thinking, decision-making, and problem-solving skills

Ability to assess patients without face-to-face interaction

Excellent communication and organizational skills

Knowledge of Indiana Nurse Practice Act

Why You’ll Love Working Here

Purpose-driven work that directly impacts access to care across our communities

Robust benefits package (medical, dental, vision) designed to support you and your family

Generous PTO because we believe caring for others starts with caring for yourself

401(k) with employer contribution to help you plan for what’s ahead

Life and disability coverage for peace of mind

Here, you are not just filling a role—you are helping shape healthier communities and advancing equitable care every day!