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Nicole Fleming, BSN RN CCM

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Bio

I proactively manage care including, but not limited to care management planning, referral management, post-discharge planning, and coordinating transitional and community based care. With a focus on delivering comprehensive patient-centered care across the health care continuum. Close collaboration with provider practices to deliver care coordination, chronic care management, coaching, consultation and intervention with a particular focus on patients with complex health care needs.
Analysis and dissemination of patient health goals/outcomes.

Currently completing a Masters in Nursing with a focus on Informatics.