Patient Health Advocate

About the role

As the largest and leading value-based kidney care company, Somatus empowers patients living with chronic kidney disease to have more days out of the hospital and healthier at home. This role is a market-based position that works under the guidance of physicians and/or a nurse care manager.

Responsibilities

• Manage caseload through in-person, telephonic, and electronic means of communications and coordination.
• Facilitate connecting and scheduling the many resources within and beyond Somatus to the patient, including the various members of our care team as well as PCPs, Nephrologists, etc.
• Conduct an initial triage assessment to help align patients with the most appropriate program in accordance with program guidelines.
• Document activities in the care coordination platform, including care plan activities conducted.
• Engage with patients who need assistance with self-care needs in addition to what a nurse care manager can provide via phone.
• Coach and guide the patient to meet both personal and clinical goals.
• Schedule provider appointments on behalf of their patients.
• Accompany patients to their appointments when needed.
• Remind patients of their upcoming appointments.
• Help patients access community and government-based services, including possibly filling out paperwork for the patient.
• Teach the caregiver about symptom response plans.
• Arrange transportation.
• Facilitate closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing.
• Absorb patients to enroll to access educational videos.
• Participate in the integrated care team meetings.
• Act as the patient advocate and support the member through their patient journey starting with initial outreach.
• Conduct telephonic outreach to members within designated geographic area to introduce the Somatus program and encourage enrollment to build their patient caseload.
• Support NP and RNCM care team members through facilitating in-home telehealth visits with patients.
• Utilize motivational interviewing techniques to encourage patients to make behavioral changes.

Qualifications

• Experience working with Medicare, Medicaid or Special Needs populations.
• Medical Assistant, Licensed Practical Nurse, Engagement Specialist or Community Health Worker Experience.
• Ability to connect with people and understand the challenges they face.
• Ability to use a range of outreach methods to engage individuals and groups in diverse settings.
• Well connected to the community and resources within the community they will serve.
• Effective written and verbal communication skills demonstrating respect and cultural awareness during interactions with clients.
• Ability to travel throughout the assigned region and comfort with conducting home visits (50-75% same day travel).
• Great motivator.
• Organized.
• Coach.
• Empathetic.
• Outgoing / positive personality.

Skills

• Experience working with patients with chronic and behavioral health needs.
• Demonstrated success in working as part of a multi-disciplinary team including communicating and working with Physicians and Registered Nurses.
• Proven experience with engaging patients in making healthy behavior changes.
• Proven skills in navigating the health systems and making necessary linkages in order to meet specific needs.
• Experience working with Electronic Medical Records and other documentation platforms.

Benefits

Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience and may fall outside of the range shown.

Pay

$21.00- $25.00 Per Hour

Schedule

Hybrid Telehealth environment with a combination of remote days and visits to members’ homes.