Healthmap Solutions is hiring a RN - Clinical Care Manager/Case Manager (Hybrid)

Healthmap Solutions is looking for a Registered Nurse, Clinical Care Manager/Case Manager to join our mission as champions for better health. In this hybrid role, you will develop long-term relationships with physicians and members to coordinate performance improvement and care management activities, directly impacting health outcomes in our Kidney Management Program.

What You'll Do

• Act as a liaison between Healthmap, provider practices, and members to ensure positive program engagement.
• Develop new provider partnerships and manage your assigned caseload.
• Identify opportunities to improve health outcomes using provider-specific data.
• Educate providers on Best Practices, workflow improvements, Kidney Health Management, and HEDIS/STAR measures.
• Educate provider offices on topics related to Chronic Kidney Disease, End Stage Renal Disease, and Renal Replacement Therapies.
• Partner with physicians to identify members for Care Navigation support, conduct outreach, and engage them in the program.
• Educate Healthmap members on kidney health, co-morbid conditions, and renal replacement therapy.
• Serve as a member advocate, connecting them with community resources and coordinating care between their support network and providers.
• Meet individual and departmental metrics and key performance indicators.
• Ensure timely delivery of reports to internal and external stakeholders.
• Maintain thorough documentation of all interactions in compliance with NCQA standards.
• Ensure compliance with Healthmap policies, HIPAA, and all federal, state, and local regulations.
• Perform other related duties as assigned.

What We're Looking For

• Bachelor's degree required.
• Active, unrestricted RN license required.
• Basic Life Support (BLS) certification required for field roles (within 30 days of hire).
• 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management.
• Proof of valid and unrestricted driver’s license; regular travel within the assigned region is required.
• Must reside in one of the assigned states.
• Must comply with organization health screening and immunization policies.

Nice to Have

• 3 years of experience in care gap closure or care coordination activities in an outpatient or hospital setting.
• Prior experience building and managing relationships with healthcare providers or patients.

Technical Stack

• Microsoft Office: Outlook, Word, Excel, PowerPoint

Benefits & Compensation

• Compensation: $78,000 - $119,000 (dependent on market/region and experience)
• Paid Time Off
• Medical, Dental, and Vision coverage
• Short Term/Long Term Disability
• 401K with match
• Other voluntary benefits as elected

Work Mode

This is a hybrid position. You must reside in one of the assigned states as the role requires regular travel within the region.

Healthmap Solutions is an Equal Opportunity Employer. We will not discriminate against any 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.