RN Care Navigator/Case Manager - Remote (Compact State & Illinois)

Position Summary

The Registered Nurse, Care Navigator/Case Manager will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective outcomes for patients and focus on the whole patient and care delivery coordination. Managing a set caseload of mixed acuity members, reviewing and/or obtaining member data and entry in HealthMap’s Care Management documentation system (Compass), completing member health and social determinants of health screenings, medication reconciliation, creation and maintaining member-centric care plans, updates of identified problems, barriers, interventions, and goals and assistance with ongoing case management. The Care Navigator will collaborate with internal and external (physicians, nurses, and other healthcare personnel) to assure positive patient outcomes and care coordination.

***** Location/License:We're looking for candidates that live in a compact RN state, but also have an active RN license in the state of Illinois.

Responsibilities

Handle in and outbound calls delivering world-class service to our members

Educate kidney health and related co-morbid conditions as well as optimizing renal replacement therapy by educating members on the types of dialysis and transplant options

Engage members into HealthMap’s Kidney Health Program

Follow up with members based on complexity and cadence by policy

Serve as patient advocate for responding and working to resolve concerns or barriers

Utilize community resources and programs in care planning

Serve as liaison between the patient, the patient’s support network, treating physician, and other ancillary providers as a member of an interdisciplinary care team to coordinate care, resolve nursing problems and assist patients in meeting individualized goals

Notify providers of identified patient needs based on policy

Comply with HIPAA privacy laws and all other federal, state, and local regulations

Comply with company-defined operational policies and procedures

Comply with company security policies

Accountable for individual metrics and key performance indicators and identified by the organization

Navigate technical applications - Excel, OneNote, Outlook, and Word

Support after hours and various time zones based on business need

Drive patient and families in their own care and to support self-management

Requirements

Active, unrestricted RN license required

Bachelor’s degree required; 6+ years of RN experience including 3+ years in case management may be considered in lieu of degree

CCM preferred

Three (3) years of experience in case management preferred

Experience in a dialysis center or transplant center preferred

Experience with Medicare and Medicaid preferred

Skills

Advocate and energize a culture of collaboration, positivity, and motivation

Strategic thinking and planning

Deliver effective communication – verbal and written

Succeed in a challenging environment with changing priorities

Travel

No Travel

Originally posted on Himalayas