Clinical Care Manager, RN

Role Overview

• Establishing and maintaining contact with assigned and active members via video, phone, text, and email.
• Obtain and utilize clinical information to develop an individualized member care plan and clinician-centered care plan per NCQA guidelines.
• Assess members health status and care coordination needs.
• Collaborate with members’ health care providers as needed.
• Utilizing motivational interviewing techniques, individualized care plans, and the Triple Aim framework to empower active members to reach their health goals.
• Understanding and explaining to new or inactive members the benefits of our Program as it relates to those with chronic kidney disease and those at risk.
• Appropriately documenting, requesting, and sending member information in accordance with HIPAA compliance.
• Meet individually performance metrics to support member engagement and retention.

Requirements

• Must have an RN license in good standing; additional state licensure is a plus.
• A minimum of five years of RN experience is required.
• Experience developing care plans for individuals with chronic conditions and/or Chronic Kidney Disease is highly preferred.
• Bilingual in Spanish is highly preferred.
• BSN is highly preferred.
• CDE or CDCES highly preferred.
• Experience working 100% remote as a nurse is highly preferred.
• Ability and willingness to travel occasionally, which will include overnight stays for corporate gatherings, conferences, and health fairs.
• Ability to attend and professionally engage in video meetings.
• Proficient technological skills, meaning you can effectively and efficiently use computers, peripheral equipment, and applications/systems, including Microsoft products.
• Autonomous self-starter who is comfortable with ambiguity.
• Creative mindset and ability to appropriately challenge the status quo.
• Superb written and oral communication skills.
• Ability to overcome obstacles with a ‘yes if...’ approach.
• Ability to effectively balance competing deadlines without losing focus on the bigger picture.
• Reliable internet and power with a designated area to conduct work with minimal interruptions.

Benefits

• Market competitive salary, including potential annual merit increases and bonuses contingent on the company's fiscal performance.
• Generous time off and paid holidays because we value recharging.
• Exceptional healthcare coverage, with the majority of medical, dental and vision premiums covered by us.
• 401k with generous employer match.