Healthmap Solutions

RN Care Navigator/Case Manager (100% Remote for candidates able to work Pacific & Mountain time zones)

Healthmap Solutions • $80K — $95K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Active, unrestricted RN license required
  • Bachelor's degree or equivalent experience (6+ years RN with 3+ years in case management)
  • CCM certification preferred
  • Three years of case management experience preferred
  • Experience in dialysis or transplant centers preferred
  • Familiarity with Medicare and Medicaid preferred

Responsibilities

  • Handle inbound and outbound calls to provide exceptional service to members
  • Educate members on kidney health and treatment options, including dialysis and transplants
  • Engage members in HealthMap's Kidney Health Program
  • Follow up with members according to policy guidelines
  • Act as a patient advocate to resolve concerns and barriers
  • Utilize community resources in care planning
  • Coordinate care as part of an interdisciplinary team, liaising with patients, families, and providers
  • Notify providers of patient needs as per policy
  • Ensure compliance with HIPAA and other regulations
  • Meet individual performance metrics and key performance indicators
  • Navigate technical applications like Excel and Outlook
  • Support after-hours needs across various time zones
  • Encourage patients and families in self-management of care

Benefits

  • Remote work opportunity covering Pacific and Mountain time zones
  • Collaborative work environment with an interdisciplinary team
  • Focus on patient-centered care and advocacy
  • Opportunity to educate and empower patients
  • Engagement with community resources for holistic care
Full Job Description
Description

Position at Healthmap Solutions

Position SummaryThe Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective outcomes for patients and focus on the whole patient and care delivery coordination. Managing a set caseload of mixed acuity members, reviewing and/or obtaining member data and entry in HealthMap's Care Management documentation system (Compass), completing member health and social determinants of health screenings, medication reconciliation, creation and maintaining member-centric care plans, updates of identified problems, barriers, interventions, and goals and assistance with ongoing case management. The Care Navigator will collaborate with internal and external (physicians, nurses, and other healthcare personnel) to assure positive patient outcomes and care coordination.

***** Location/License: We're hiring Care Navigators/Case Managers that are able to virtually cover the Pacific and Mountain time zones.

Responsibilities
  • Handle in and outbound calls delivering world-class service to our members
  • Educate kidney health and related co-morbid conditions as well as optimizing renal replacement therapy by educating members on the types of dialysis and transplant options
  • Engage members into HealthMap's Kidney Health Program
  • Follow up with members based on complexity and cadence by policy
  • Serve as patient advocate for responding and working to resolve concerns or barriers
  • Utilize community resources and programs in care planning
  • Serve as liaison between the patient, the patient's support network, treating physician, and other ancillary providers as a member of an interdisciplinary care team to coordinate care, resolve nursing problems and assist patients in meeting individualized goals
  • Notify providers of identified patient needs based on policy
  • Comply with HIPAA privacy laws and all other federal, state, and local regulations
  • Comply with company-defined operational policies and procedures
  • Comply with company security policies
  • Accountable for individual metrics and key performance indicators and identified by the organization
  • Navigate technical applications - Excel, OneNote, Outlook, and Word
  • Support after hours and various time zones based on business need
  • Drive patient and families in their own care and to support self-management

Requirements
  • Active, unrestricted RN license required
  • Bachelor's degree required; 6+ years of RN experience including 3+ years in case management may be considered in lieu of degree
  • CCM preferred
  • Three (3) years of experience in case management preferred
  • Experience in a dialysis center or transplant center preferred
  • Experience with Medicare and Medicaid preferred

Skills
  • Advocate and energize a culture of collaboration, positivity, and motivation
  • Strategic thinking and planning
  • Deliver effective communication - verbal and written
  • Succeed in a challenging environment with changing priorities

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About Healthmap Solutions

Healthmap Solutions is a healthcare company that provides technology-enabled services to help healthcare organizations improve patient outcomes and reduce costs. They offer a range of services including care management, population health management, and risk adjustment. The company was founded in 2010 and is headquartered in Oxnard, California. They have a team of experienced healthcare professionals who work closely with clients to develop customized solutions that meet their specific needs. Healthmap Solutions has worked with a variety of clients across different sectors of the healthcare industry, including health plans, provider groups, and government agencies.
Learn more about Healthmap Solutions
Size
200 employees
Industry
Founded
2010

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