RN Care Navigator/Case Manager - Remote

About the Role

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, focusing on the whole patient and care delivery coordination. Responsibilities include managing a caseload of mixed acuity members, reviewing and obtaining member data, completing health and social determinants of health screenings, medication reconciliation, creating and maintaining member-centric care plans, and collaborating with internal and external healthcare personnel to ensure positive patient outcomes.

We're looking for candidates with an active compact RN license to cover Idaho and surrounding states. An active Oregon RN license is a plus but not required.

Responsibilities

• Handle inbound and outbound calls delivering world-class service to members
• Educate members on kidney health, related co-morbid conditions, and renal replacement therapy options (dialysis, transplant)
• Engage members in HealthMap’s Kidney Health Program
• Follow up with members based on complexity and policy-defined cadence
• Serve as a patient advocate to resolve concerns or barriers
• Utilize community resources and programs in care planning
• Act as a liaison between the patient, their support network, treating physicians, and ancillary providers as part of an interdisciplinary care team
• Coordinate care and assist patients in meeting individualized goals
• Notify providers of identified patient needs based on policy
• Comply with HIPAA privacy laws and all federal, state, and local regulations
• Adhere to company-defined operational and security policies
• Meet individual metrics and key performance indicators set by the organization
• Navigate technical applications (Excel, OneNote, Outlook, Word)
• Support after-hours and various time zones as needed
• Empower patients and families to support self-management

Requirements

• Active, unrestricted RN license (compact license required; Oregon license a plus)
• Bachelor’s degree in Nursing (or 6+ years of RN experience, including 3+ years in case management, in lieu of degree)
• Certified Case Manager (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 for and energize a culture of collaboration, positivity, and motivation
• Strategic thinking and planning
• Effective verbal and written communication
• Ability to succeed in a challenging environment with changing priorities

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.