Job Description

RN Clinical Case Manager - Hybrid! Position Summary: The RN Clinical Care Manager/Case Manager is responsible for developing and maintaining long-term relationships with physicians, physician office staff, and Healthmap members that are engaged in Healthmap’s Kidney Management Program through coordinating performance improvement activities and care management to improve health outcomes. Responsibilities:

• 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

Healthmap Solutions (Healthmap) is an NCQA-accredited kidney population health management company. Healthmap uses advanced technology, clinical expertise, and complex care management to improve the lives of people living with kidney disease. Healthmap also helps healthcare providers and payers achieve the value-based results they need. Our company is a diverse and growing organization committed to our clients, the patients we support, and our employees. We are champions for better health, for those who need us most.

Job Tags

Work at office, Local area,

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