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

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. This role involves managing a caseload of mixed acuity members, reviewing and obtaining member data, completing health and social determinants of health screenings, medication reconciliation, and creating member-centric care plans. The Care Navigator will collaborate with internal and external healthcare personnel to ensure positive patient outcomes and care coordination.

Location/License: Active RN license in the state of New York 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 and 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 other providers to coordinate care
• 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 such as 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 required
• Bachelor’s degree required; 6+ years of RN experience, including 3+ years in case management, may be considered 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 the essential functions.

Travel

No travel required.