RN Care Navigator/Case Manager - Remote (NY State RN license required)

Case management role focused on kidney health, coordinating care for a caseload of mixed-acuity patients to ensure high-quality, cost-effective outcomes. Responsibilities include health and social determinants screenings, medication reconciliation, care plan development, and interdisciplinary collaboration.

Responsibilities

• Handle inbound and outbound calls to deliver world-class service to members.
• Educate members on kidney health, related co-morbid conditions, and renal replacement therapy options (dialysis, transplant).
• Engage members in the HealthMaps Kidney Health Program.
• Follow up with members based on complexity and policy-driven cadence.
• Serve as a patient advocate to resolve concerns or barriers to care.
• Utilize community resources and programs in care planning.
• Act as a liaison between patients, their support networks, physicians, and ancillary providers to coordinate care and meet individualized goals.
• Notify providers of identified patient needs per policy.
• Comply with HIPAA, federal, state, and local regulations, as well as company operational and security policies.
• Meet individual metrics and key performance indicators set by the organization.
• Navigate technical applications: Excel, OneNote, Outlook, and Word.
• Support after-hours and various time zones as needed.
• Empower patients and families to support self-management.

Requirements

• Active, unrestricted RN license in the state of New York.
• Bachelor’s degree required; 6+ years of RN experience (including 3+ years in case management) may substitute for the degree.
• Three years of case management experience preferred.
• Experience in a dialysis center or transplant center preferred.
• Certified Case Manager (CCM) 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.