{"id":107864,"date":"2026-08-14T09:25:50","date_gmt":"2026-08-14T09:25:50","guid":{"rendered":"https:\/\/jobs.dataaxisnode.com\/kenya\/uncategorized\/chronic-care-lead-nurse\/"},"modified":"2026-08-14T09:25:50","modified_gmt":"2026-08-14T09:25:50","slug":"chronic-care-lead-nurse","status":"publish","type":"post","link":"https:\/\/jobs.dataaxisnode.com\/kenya\/jobs\/nairobi\/chronic-care-lead-nurse\/","title":{"rendered":"Chronic Care Lead Nurse"},"content":{"rendered":"<p><script type=\"application\/ld+json\">{\"@context\": \"https:\/\/schema.org\/\", \"@type\": \"JobPosting\", \"title\": \"Chronic Care Lead Nurse\", \"description\": \"Job Objective\/Purpose\\nThe Chronic Care Lead Nurse performs care management for chronically ill patients with chronic diseases such as chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease, and\/or congestive heart failure. The Chronic Care nurse works in collaboration and continuous partnership with chronically ill patients and their family\/caregivers, clinic providers and community resources in a team approach to increase patients\u2019 ability for self-management and shared decision- making.\\nKey Responsibilities\\nFulfill the Avenue health care mission to provide high quality care that exceeds our client expectation with the goal to deliver through courteous, respect and compassionate manner.\\nResponsible for registry of chronic care management CCM to patients.\\nValidates enrollment of CCM patients based on provider request\\nComply with documentation requirements of the Chronic Care Management program by carrying out the care plan with the patient, family\/caregivers and providers and recording in the EMR.\\nMonitors adherence to care plans, evaluates effectiveness, monitors patient progress in a timely manner, and facilitates changes as needed.\\nCreates an ongoing process for patient and family\/caregiverss to determine and request the level of care coordination support they desire.\\nFacilitates patient access to appropriate medical and specialty providers.\\nCoordinates transition of inpatient to outpatient care in an effort to decrease readmission rates\\nWork closely with in-office providers to manage the day to day calls involving: symptom control, medication management, and provide patient and family education\\nEducates patient and family\/caregivers about relevant community resources.\\nAssist with the identification of \u201chigh-risk\u201d patients the chronically ill and those with special health care needs, and assist on the enrollment of these to the patient registry.\\nCoordinates continuity of patient care with external healthcare organizations and facilities including from the primary care provider to a specialty care provider.\\nSupports patient self-management of disease and behavior modification interventions.\\nProvides patient health counseling, education and instruction.\\nAny other duty assigned by your immediate supervisor in line with the job description.\\nPerson Specification\\nGraduate of an accredited nursing school as a Registered Nurse with a Diploma\/Degree in Nursing, valid license with the Nursing Council of Kenya.\\nUpdated BLS, ACLS\/ATLS certificate\\nMinimum of 3 years' work experience in a healthcare setting involving patients with complex chronic disease states preferred.\\nCustomer focus, empathetic and emotional intelligence\\nStrong interpersonal and communication skills\\nOrganizational awareness and attention to detail\\nTeam work and result oriented\\nEthical and reliable\\nEnd date 21st August 2026\", \"datePosted\": \"2026-08-13\", \"hiringOrganization\": {\"@type\": \"Organization\", \"name\": \"Avenue Healthcare\"}, \"jobLocation\": {\"@type\": \"Place\", \"address\": {\"@type\": \"PostalAddress\", \"addressLocality\": \"Nairobi\", \"addressCountry\": \"KE\"}}, \"directApply\": true, \"validThrough\": \"2026-08-26T23:59:59\", \"employmentType\": \"FULL_TIME\"}<\/script><\/p>\n<p><strong>Company:<\/strong> Avenue Healthcare<\/p>\n<p><strong>Location:<\/strong> Nairobi<\/p>\n<p><strong>Job Type:<\/strong> Full Time<\/p>\n<p><strong>Apply Before:<\/strong> 2026-08-26<\/p>\n<h3>Job Description<\/h3>\n<p>Job Objective\/Purpose<br \/>The Chronic Care Lead Nurse performs care management for chronically ill patients with chronic diseases such as chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease, and\/or congestive heart failure. The Chronic Care nurse works in collaboration and continuous partnership with chronically ill patients and their family\/caregivers, clinic providers and community resources in a team approach to increase patients\u2019 ability for self-management and shared decision- making.<br \/>Key Responsibilities<br \/>Fulfill the Avenue health care mission to provide high quality care that exceeds our client expectation with the goal to deliver through courteous, respect and compassionate manner.<br \/>Responsible for registry of chronic care management CCM to patients.<br \/>Validates enrollment of CCM patients based on provider request<br \/>Comply with documentation requirements of the Chronic Care Management program by carrying out the care plan with the patient, family\/caregivers and providers and recording in the EMR.<br \/>Monitors adherence to care plans, evaluates effectiveness, monitors patient progress in a timely manner, and facilitates changes as needed.<br \/>Creates an ongoing process for patient and family\/caregiverss to determine and request the level of care coordination support they desire.<br \/>Facilitates patient access to appropriate medical and specialty providers.<br \/>Coordinates transition of inpatient to outpatient care in an effort to decrease readmission rates<br \/>Work closely with in-office providers to manage the day to day calls involving: symptom control, medication management, and provide patient and family education<br \/>Educates patient and family\/caregivers about relevant community resources.<br \/>Assist with the identification of \u201chigh-risk\u201d patients the chronically ill and those with special health care needs, and assist on the enrollment of these to the patient registry.<br \/>Coordinates continuity of patient care with external healthcare organizations and facilities including from the primary care provider to a specialty care provider.<br \/>Supports patient self-management of disease and behavior modification interventions.<br \/>Provides patient health counseling, education and instruction.<br \/>Any other duty assigned by your immediate supervisor in line with the job description.<br \/>Person Specification<br \/>Graduate of an accredited nursing school as a Registered Nurse with a Diploma\/Degree in Nursing, valid license with the Nursing Council of Kenya.<br \/>Updated BLS, ACLS\/ATLS certificate<br \/>Minimum of 3 years&#8217; work experience in a healthcare setting involving patients with complex chronic disease states preferred.<br \/>Customer focus, empathetic and emotional intelligence<br \/>Strong interpersonal and communication skills<br \/>Organizational awareness and attention to detail<br \/>Team work and result oriented<br \/>Ethical and reliable<br \/>End date 21st August 2026<\/p>\n<h3>How to Apply<\/h3>\n<p>Interested and qualified? Go to Avenue Healthcare on careers.avenuehealthcare.com to apply<br \/>Build your CV for free. Download in different templates.<\/p>\n<p><a href=\"https:\/\/www.myjobmag.co.ke\/apply-now\/1306055\" target=\"_blank\" rel=\"noopener\" style=\"display:inline-block;padding:10px 20px;background:#2271b1;color:#fff;text-decoration:none;border-radius:4px;\">Apply Now<\/a><\/p>\n<p><small>Source: MyJobMag<\/small><\/p>\n<p><!-- job-expiry: 2026-08-26 --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Company: Avenue Healthcare Location: Nairobi Job Type: Full Time Apply Before: 2026-08-26 Job Description Job Objective\/PurposeThe Chronic Care Lead Nurse performs care management for chronically ill patients with chronic diseases such as chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease, and\/or congestive heart failure. The Chronic Care nurse works in collaboration and continuous partnership [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1408,1409],"tags":[1780,1425,1413,1412],"class_list":["post-107864","post","type-post","status-publish","format-standard","hentry","category-jobs","category-nairobi","tag-avenue-healthcare","tag-full-time","tag-job-listing","tag-myjobmag"],"_links":{"self":[{"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/posts\/107864","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/comments?post=107864"}],"version-history":[{"count":0,"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/posts\/107864\/revisions"}],"wp:attachment":[{"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/media?parent=107864"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/categories?post=107864"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/kenya\/wp-json\/wp\/v2\/tags?post=107864"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}