As part of our practice transformation into a high quality patient-centered medical home (PCMH) and achieving the Triple Aim, our residency program felt incorporating a nurse care manager (NCM) would be an invaluable asset to help our residents manage the complex transitions of care and to better manage chronic disease states in our patients. Placing a NCM in our residency practice has demonstrably improved our transitions of care, chronic disease management, and our ability to achieve savings through a Medicare Shared Savings Program (MSSP). This session will have participants use audience response to gauge their progress in practice transformations. We will discuss the process our residency used to secure a NCM and the many roles that she has filled within our residency practice. Improvements to our practice include, but are not limited to, enhanced savings through MSSP, lower ER utilization, and improved HbgA1c levels among diabetic patients. We will discuss the learning opportunities that have been made available to our residents, including use of a NCM for transitions from the inpatient service to the outpatient setting. We will conclude with audience discussion of the barriers to having a NCM and how we addressed our specific issues.