Healthmap Solutions is hiring a Healthmap Solutions Careers - RN Clinical Care Manager ...

Healthmap Solutions is looking for an RN Clinical Care Manager to join our mission as champions for better health, for those who need us most. In this role, you will develop and maintain long-term relationships with physicians, physician office staff, and Healthmap members engaged in our Kidney Management Program, coordinating performance improvement activities to drive better health outcomes.

What You'll Do

• Act as a liaison between Healthmap, provider practices, and members to ensure positive engagement and performance.
• Develop new provider and partner business relationships to better manage your assigned caseload.
• Identify opportunities to improve member health outcomes based on provider-specific data.
• Incorporate education on Best Practices, process improvement, Kidney Health Management interventions, and HEDIS/STAR measures.
• Identify opportunities to educate provider offices on Chronic Kidney Disease, End Stage Renal Disease, and Renal Replacement Therapies.
• Partner with physicians and their staff to identify members for Care Navigation support, conduct outreach, and engage members.
• Educate Healthmap members on kidney health, related co-morbid conditions, and renal replacement therapy.
• Serve as a member advocate, utilize community resources, and act as a liaison between the member, their support network, treating physician, and ancillary providers.
• Be accountable for individual and departmental metrics and key performance indicators.
• Ensure timely and successful delivery of reports to internal and external stakeholders.
• Maintain thorough documentation of all provider and member interactions in compliance with NCQA standards.
• Ensure all actions comply with Healthmap policies, HIPAA, and all other federal, state, and local regulations.

What We're Looking For

• Bachelor's degree.
• Active, unrestricted RN license.
• Basic Life Support (BLS) certification.
• 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management.
• Proof of a valid and unrestricted driver’s license.
• Must reside in one of the assigned states.
• Must comply with organization policies for health screening and immunizations (TB test/chest X-ray, proof of immunizations, participation in annual screenings).

Nice to Have

• Advanced Cardiovascular Life Support (ACLS) certification.
• 3 years of experience in care gap closure or care coordination activities, including in an outpatient or hospital setting.
• Prior experience building and managing relationships with healthcare providers or patients.

Technical Stack

• Microsoft Office Suite: Outlook, Word, Excel, PowerPoint.

Benefits & Compensation

• Compensation range: $105,000 - $143,000.
• Paid Time Off.
• Medical, Dental, and Vision insurance.
• Short Term and Long Term Disability coverage.
• 401K with company match.
• Other voluntary benefits as elected.

Work Mode

This position offers a hybrid work model.

As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy.