Job Description
About Us
We are a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, we leverage remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, we empower our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Position Overview
As an RN Case Manager, you will partner with clinical teams to provide complex case management and strengthen the connection between patients and primary care physicians/medical practice staff. Your role is to assist patients in achieving their highest level of wellness by managing a specific patient population, including those with complex medical conditions, socio-economic challenges, and/or mental health co-morbidities. You will optimize patient health through assessment, planning, implementation, coordination, monitoring, and evaluation of available options and services. You will collaborate with approximately five patient care navigators and other members of a patient's care team to achieve optimal quality, clinical, and financial outcomes.
Location and Travel
This is a remote position that will require travel as needed (10%-15%). We are currently considering candidates who live or plan to live within 90 minutes of Houston. We appreciate your understanding.
Key Responsibilities
Conduct comprehensive assessments of healthcare and psychosocial needs of patients
Review and amend patient navigator interviews with patients
Develop, implement, and maintain individualized care plans in accordance with internal protocols and accreditation standards
Provide evidence-based clinical interventions based on individualized care plan goals
Partner with patient navigators to manage non-clinical elements of the care plan, such as making appointments, arranging transportation or food services, or other social determinants of health (SDOH)/non-medical patient needs
Provide ongoing outreach to patients, continuously monitor patient data, and adjust plans of care accordingly
Develop patient-specific escalation plans with the PCP in the event of acute, non-emergent exacerbations of key chronic conditions
Educate patients regarding conditions and treatment options
Serve as an advocate for patients and assist with accessing and engaging with services/resources requiring clinical licensing, training, or knowledge
Follow up on service or resource referrals
Maintain up-to-date documentation in the electronic medical health record as defined by protocol
Utilize evidence-based clinical protocols and guidelines along with defined quality metrics
Qualifications
Licensed Registered Nurse in good standing
3+ years of RN Case Management experience in an outpatient setting
CCM certification preferred; must obtain CCM within one year of employment
Supervisory experience preferred
Excellent written and oral communication skills to empathetically interact with patients, families, and the interdisciplinary team
Proficient computer skills, including the ability to learn multiple EMR and Case Management documentation systems
Ability to meet accreditation and quality standards, including but not limited to NCQA and HEDIS
Bilingual in English and Spanish preferred
Benefits
While you are hard at work advancing value-based healthcare, we are here to ensure you have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Enjoy the flexibility of a fully remote position, allowing you to focus on your professional goals and personal needs without the commute.
Health Coverage: Comprehensive Medical, Dental, and Vision plans to keep you covered.
Retirement Plans: 401(k) plan with a 3% employer match to your 6% contribution.
Insurance: Life and Disability insurance for those "just in case" moments, plus voluntary Life options.
Supportive Programs: Employee Assistance Program (EAP) to help you through tough times.
Flexible Time Off: Tailored to meet your needs and the needs of the business, helping you achieve work-life balance and meet personal goals.
Parental Leave: Paid leave to support you in welcoming a new family member.
Learning and Development: Resources dedicated to your professional growth to advance your career with us.
Compensation
The base pay range for this role is between $80,000 to $85,000 per year, paid bi-weekly. Final base pay decisions are dependent upon a variety of factors, including but not limited to skill set, years of relevant experience, education, location, and licensure/certifications.
Our Commitment to Equal Opportunity Employment
Diversity, inclusion, and belonging are core values. We are an equal opportunity employer and make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth, or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. We are dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
This position is responsible for following all Security policies and procedures to protect all PHI under our custodianship, as well as intellectual properties. For any security-specific roles, the responsibilities will be further defined by the hiring manager.
Employment Type: Full-Time
Salary: $ 80,000.00 85,000.00 Per Year
Job Tags
Weekly pay, Full time, Local area, Flexible hours,