The Nephrology Extender provides coordination of quality care for CKD and ESRD patients between primary care physicians, community nephrologists and dialysis clinics. Reporting to the National Director of Nephrology, the incumbent will be responsible for identifying opportunities to minimize fragmentation of health care for ESRD and CKD patients. They will continually seek to improve patient and quality outcomes, monitoring program performance across multiple medical centers. They will be responsible for patient education and will help develop strategies for quality improvement and management.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:- Works directly with the National Director of Nephrology to analyze care gaps sharing recommendations with PCPs and dialysis clinics to decrease crash into dialysis.
- Responsible for care coordination between ChenMed Nephrology team, PCPs, Dialysis units and vascular or inpatient care facilities.
- Ability to review patient charts, provide assessments and recommendations for care plan.
- Enhances home dialysis utilization for patients with emphasis on increasing de-novo start of home dialysis.
- Works with transitional care team on decreasing ESRD hospitalizations and length of stay
- Provides virtual education to patients on CKD and options for dialysis.
- Develops trusting relationships with all internal and external stakeholders to determine areas of opportunity supplemented with remediation strategies.
- Supports and completes ad-hoc initiatives including, but not limited to research and care advancement proposals.
- Ability to travel up to 75%
- Other duties as assigned.
Scope of Work and KPI's:A. Late-stage CKD (near dialysis) patients:a. Analyze gaps in care and make recommendations to Dr Kheda/PCP
b. Nephrology and transplant referral management
c. Chart reviews and provide assessment if candidate for home dialysis'
d. Assist in development of CKD patient education material
e. Provide virtual education to patients on CKD and dialysis options
f. Care coordinate with community nephrologist to avoid 'Crashing into Dialysis'
g. Increase de-novo start of home dialysis
h. Decrease Crash into Dialysis
B. ESRD on hemodialysis:a. Analyze gaps in care and make recommendations to Dr Kheda/PCP/dialysis clinics
b. Do virtual assessment if candidate to transition to home dialysis
c. Care coordination with TCM team on decreasing ESRD hospitalizations and LOS
d. Care coordinate between ChenMed, Dialysis unit, vascular and inpatient care
e. Increase proportion of patients on home dialysis
f. Decrease hospitalization rate and LOS
EDUCATION AND EXPERIENCE CRITERIA:- Licensed Physician Assistant or Nurse Practitioner with 5+ years of nephrology experience
- Nephrology CAQ or Certified Nephrology Nurse (CNN) preferred
- Experience with care coordination and coaching
- Excellent verbal and written communication skills
- Intermediate computer skills with Microsoft Office Suite products, including Excel and Word
- Medicare and/or Medicare Advantage experience a plus
- Prior experience in a value based care (e.g. ESCO) , risk-model based healthcare a plus
PAY RANGE:$111,140 - $158,771 Salary
The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITShttps://chenmed.makeityoursource.com/helpful-documents
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