RN Care Navigator/Case Manager - 100% Remote (Compact State & Oregon RN licenses
Required skills
- RN license
- Compact State
- Oregon
- kidney health
- case management
- care coordination
- HIPAA
- Excel
- OneNote
- Outlook
Nice to have
- CCM
- dialysis center
- transplant center
- Medicare
- Medicaid
Role summary
The Registered Nurse, Care Navigator/Case Manager is a 100% remote position responsible for kidney health management. This role involves coordinating care across the continuum, managing a caseload of mixed acuity members, conducting screenings, medication reconciliation, and developing member-centric care plans. The Care Navigator collaborates with internal and external healthcare professionals to ensure positive patient outcomes and facilitate self-management. Key responsibilities include patient education on kidney health and renal replacement therapies, serving as a patient advocate, utilizing community resources, and maintaining documentation in the Compass system. Proficiency in Microsoft Office Suite and adherence to HIPAA regulations are required.
Position SummaryThe 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 and focus on the whole patient and care delivery coordination. Managing a set caseload of mixed acuity members, reviewing and/or obtaining member data and entry in HealthMap’s Care Management documentation system (Compass), completing member health and social determinants of health screenings, medication reconciliation, creation and maintaining member-centric care plans, updates of identified problems, barriers, interventions, and goals and assistance with ongoing case management. The Care Navigator will collaborate with internal and external (physicians, nurses, and other healthcare personnel) to assure positive patient outcomes and care coordination.
***** Location/License:We're looking for candidates that live in a compact RN state, but also have an active RN license in the state of Oregon.Responsibilities
- Handle in and outbound calls delivering world-class service to our members
- Educate kidney health and related co-morbid conditions as well as optimizing renal replacement therapy by educating members on the types of dialysis and transplant options
- Engage members into HealthMap’s Kidney Health Program
- Follow up with members based on complexity and cadence by policy
- Serve as patient advocate for responding and working to resolve concerns or barriers
- Utilize community resources and programs in care planning
- Serve as liaison between the patient, the patient’s support network, treating physician, and other ancillary providers as a member of an interdisciplinary care team to coordinate care, resolve nursing problems and assist patients in meeting individualized goals
- Notify providers of identified patient needs based on policy
- Comply with HIPAA privacy laws and all other federal, state, and local regulations
- Comply with company-defined operational policies and procedures
- Comply with company security policies
- Accountable for individual metrics and key performance indicators and identified by the organization
- Navigate technical applications - Excel, OneNote, Outlook, and Word
- Support after hours and various time zones based on business need
- Drive patient and families in their own care and 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
- 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 and energize a culture of collaboration, positivity, and motivation
- Strategic thinking and planning
- Deliver effective communication – verbal and written
- Succeed in a challenging environment with changing priorities
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