Position Summary
The Registered Nurse, Care Navigator 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.

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

Travel
No Travel

Originally posted on Himalayas

Healthmap Solutions

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