Care Manager - Registered Nurse

Position

Monogram Health is seeking a skilled Registered Nurse eager to make a difference in patients' lives.

About the role

The Care Manager RN is a key member of an integrated Care Team including an Advanced Practice Provider and a Social Worker. Patients often struggle with multiple serious diseases. The RN helps patients improve their quality of life in the home and slows the progression of kidney disease, promoting positive health outcomes.

Highlights & Benefits

• Flexible scheduling with a hybrid and in-home model
• Competitive compensation and a performance-based bonus program
• Full benefits package including medical, dental, vision, life insurance, 401(k) plan with matching contributions, paid vacation and holiday time

Roles and Responsibilities

• Work closely with patients’ medical providers to develop and continually adapt care plans
• Perform in-home care management visits to execute care management plans
• Monitor biometric data and follow approved protocols for any necessary interventions
• Inventory and reconcile medications and coordinate with pharmacists and prescribers
• Perform patient health assessments and surveys as required
• Deliver individual and group education on CKD, ESRD, dialysis and associated comorbidities
• Encourage medication and treatment adherence through frequent contact with patients
• Engage family and social support groups in the education and care of patients
• Serve as the primary point of contact and be the first call when patients have questions (business hours)
• Provide education and coaching around medications, medical conditions, diet, exercise, and lifestyle choices
• Encourage proactive care decisions, especially relating to Advance Care Plans and ESRD treatment modalities
• Obtain vital signs when visiting patients and escalate any concerns to the provider
• Document patient updates and progress in care management platform
• Coordinate with dialysis providers to ensure transitions of care are seamless

Requirements

• Frequent local travel to perform in-home visits
• Basic Life Support (BLS) certification required in this role
• Self-starter with the ability to work independently with minimal supervision
• Ability to show empathy and quickly build relationships with patients and physicians
• Graduate of an accredited School of Nursing
• Currently licensed as a Registered Nurse in the State of the posted location
• 2+ years previous experience working in care management and/or with CKD/ESRD patients
• Excellent verbal communication skills both in person and on the phone
• Familiarity with Microsoft Office and mobile phone and web-based applications

About Monogram Health

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. We take a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders. We employ a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counseling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. We are available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home. Monogram Health is based in Nashville, Tennessee, operates throughout 37 states, and is privately held by Frist Cressey Ventures, Norwest Venture Partners, TPG Capital, as well as other leading strategic and financial investors.