Healthmap Solutions

RN Care Navigator/Case Manager - Remote (NY State RN license required)

Healthmap Solutions$75K — $90K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Active RN license in New York required
  • Bachelor's degree or equivalent experience through 6+ years of RN experience including 3+ years in case management
  • CCM certification preferred
  • Experience in a dialysis or transplant center preferred
  • Familiarity with Medicare and Medicaid preferred

Responsibilities

  • Handle in and outbound calls providing exceptional service to members
  • Educate members on kidney health and related conditions
  • Engage members in HealthMap's Kidney Health Program
  • Follow up with complex cases as per policy guidelines
  • Advocate for patients by addressing concerns and barriers
  • Utilize community resources effectively in care planning
  • Coordinate care between patients, their networks, and medical teams
  • Alert providers to patient needs as mandated by policy
  • Adhere to HIPAA and all relevant regulations
  • Comply with company operational and security policies
  • Meet metrics and performance indicators as set by the organization
  • Navigate technical tools including Excel and Outlook
  • Support after-hours calls based on business needs
  • Empower patients to take charge of their health

Benefits

  • Opportunity to work in a remote position
  • Engagement with an interdisciplinary care team
  • Focus on patient-centered care and advocacy
  • Opportunity to impact kidney health outcomes
  • Support for professional development in nursing and case management
Full Job Description
Description

Position at Healthmap Solutions

Position SummaryThe Registered Nurse, Care Navigator/Case Manager 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 looking for candidates that have an active RN license in the state of New York.

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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#LI-Remote

Americans with Disability Specifications

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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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