The Registered Nurse Clinical Care Manager plays a vital role in advancing patient outcomes within Healthmap Solutions' Kidney Management Program. This position serves as a bridge between providers, members, and the organization, driving engagement and performance through coordinated care, education, and advocacy.
What You'll Do
- Act as a liaison between Healthmap, provider practices and Healthmap members to ensure positive engagement and performance with our program(s)
- Develop new provider/partner business relationships that serve as means to better Healthmap provider and member engagement and manage assigned caseload
- Identify opportunities to improve health outcomes for Healthmap Solutions members based on provider specific data
- Incorporate education and communication on Best Practice sharing, process improvement in provider workflows, Kidney Health Management interventions and HEDIS/STAR measures for identified areas of provider low performance
- Identify opportunities to educate provider offices on topics related to Chronic Kidney Disease, End Stage Renal Disease, Renal Replacement Therapies, etc.
- Partner with physicians/physician staff to identify Healthmap Solutions members that would benefit from Care Navigation support, conduct outreach, and engage members in program
- Educate Healthmap members on kidney health, related co-morbid conditions, and renal replacement therapy
- Serve as Healthmap member advocate, utilize community resources and programs, and serve as liaison between the member, the member’s support network, treating physician, and ancillary providers to assist members in meeting individualized goals
- Accountable for individual and departmental metrics and key performance indicators as identified by the organization
- Ensure timely and successful delivery of reports to internal and external stakeholders
- Maintain thorough documentation of all provider meetings/interactions and member interactions for consistency and coordination and in compliance with National Committee for Quality Assurance (NCQA) standards
- Ensure Healthmap policies and procedures are followed and complies with HIPAA privacy laws and all other 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 all 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 required; this position requires regular travel within assigned region to support practices
- Must reside in one of the assigned states
- Must comply with organization policies for health screening and immunizations, including but not limited to: Current Tuberculosis (TB) test or current chest X-ray
- Must comply with organization policies for health screening and immunizations, including but not limited to: Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza)
- Must comply with organization policies for health screening and immunizations, including but not limited to: Participation in annual health and wellness screenings
Nice to Have
- 3 years of experience in care gap closure or care coordination activities, including those in an outpatient or hospital setting preferred
- Prior experience building and managing relationships with health care providers or patients preferred
Technical Stack
- Microsoft Office: Outlook, Word, Excel, PowerPoint
Benefits & Compensation
- Heavy Travel, greater than 50%, across your assigned region
Work Mode
Hybrid role based in Nashville.
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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
