Our mission is to enhance healthcare affordability for patients and restore the fulfillment of practicing medicine for providers. As a physician-led company, we recognize that streamlining administrative tasks and harnessing the power of predictive analytics and AI enables our partner physician practices to prioritize delivering high-quality healthcare focused on outcomes and value.
Driven by empathy, we empower physicians to anticipate the needs of patients requiring more attention, strengthen connections between patients and physicians with virtually-embedded Healthguides, and leverage AI and analytics to proactively avoid preventable events. This approach results in increased levels of patient and practice engagement, ultimately leading to more significant positive impacts on patients.
Join us as we put healthcare on a better path!
Your Role: RN Case Manager
As an RN Case Manager, you will partner with clinical teams to provide complex case management and strengthen the connection between the patient and the primary care physician/medical practice staff. Your role is crucial in assisting patients to achieve their highest level of wellness, managing a specific patient population that includes complex medical conditions, socioeconomic challenges, and/or mental health co-morbidities.
You will optimize the patient's health status through assessment, planning, implementation, coordination, monitoring, and evaluation of the options and services available. You will collaborate with patient care navigators and other members of a patient's care team to achieve optimal quality, clinical, and financial outcomes.
This is a remote position with required travel (10%-15%). We are only considering candidates who live or plan to live within 90 minutes of Houston. Thank you for your understanding.
Key Responsibilities
Comprehensively assess the healthcare and psychosocial needs of patients.
Review and amend patient navigator interviews with the patient.
Develop, implement, and maintain individualized care plans in accordance with all internal protocols and accreditation standards.
Provide evidence-based clinical interventions based on individualized care plan goals.
Partner with patient navigators to manage non-clinical elements of the care plan, such as making appointments, arranging transportation, or addressing other social determinants of health/non-medical patient needs.
Provide ongoing outreach to patients, continuously monitor patient data, and adjust care plans accordingly.
Develop patient-specific escalation plans with the PCP in the event of acute, non-emergent exacerbations of key chronic conditions.
Educate patients regarding conditions and treatment options.
Serve as an advocate for patients, assisting with accessing and engaging with services/resources that require clinical licensing, training, or knowledge.
Follow up on service or resource referrals.
Maintain up-to-date documentation in the electronic medical health record as defined by protocol.
Utilize evidence-based clinical protocols and guidelines along with defined quality metrics.
Qualifications
Licensed Registered Nurse in good standing.
3+ years of RN Case Management experience in an outpatient setting.
CCM certification preferred (must obtain CCM within 1 year of employment).
Supervisory Experience Preferred.
Excellent written and oral communication skills to empathetically interact with patients, families, and the interdisciplinary team.
Proficiency in computer skills, including the ability to learn multiple EMR and Case Management documentation systems.
Ability to meet accreditation and quality standards, including but not limited to NCQA and HEDIS.
Preferred Qualifications
Bilingual in English and Spanish preferred.
Compensation And Benefits
Our compensation structure includes more than just a base salary. We offer world-class benefits, including comprehensive medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match. Our paid time off program includes paid holidays and flexible time that focuses on meeting the demands of the position and our clients while providing the balance our employees need.
The base pay range for this role is between $80k to $85k per year, paid bi-weekly. Final base pay decisions are dependent upon factors including skill set, years of relevant experience, education, location, and licensure/certifications.
Equal Opportunity Employment
Diversity, inclusion, and belonging are at the core of our values. We are an equal opportunity employer, making employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth, or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.
This position is responsible for following all Security policies and procedures to protect all PHI under our custodianship as well as our Intellectual Properties. For any security-specific roles, the responsibilities will be further defined by the hiring manager.
Employment Type: Full-Time
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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