Qureos Mentor

Healthmap Solutions

<div>Position Summary
The Registered Nurse, Clinical Care Manager is responsible for developing and maintaining long-term relationships with physicians, physician office staff, and Healthmap members that are engaged in Healthmap&rsquo;s Kidney Management Program through coordinating performance improvement activities and care management to improve health outcomes.
Location:<div>
This position currently covers the following SC Counties: Marlboro, Dillon, Marion, Horry, Georgetown, Williamsburg, Florence, Clarendon, Sumter, Lee, and Darlington.</div>
Responsibilities<ul><li>
Act as a liaison between Healthmap, provider practices and Healthmap members to ensure positive engagement and performance with our program(s)</li><li>
Develop new provider/partner business relationships that serve as means to better Healthmap provider and member engagement and manage assigned caseload</li><li>
Identify opportunities to improve health outcomes for Healthmap Solutions members based on provider specific data</li><li>
Incorporate education and communication on Best Practice sharing, process improvement in provider workflows, Kidney Health Management interventions and HEDIS/STAR measures for identified areas of provider low performance</li><li>
Identify opportunities to educate provider offices on topics related to Chronic Kidney Disease, End Stage Renal Disease, Renal Replacement Therapies, etc.</li><li>
Partner with physicians/physician staff to identify Healthmap Solutions members that would benefit from Care Navigation support, conduct outreach, and engage members in program</li><li>
Educate Healthmap members on kidney health, related co-morbid conditions, and renal replacement therapy</li><li>
Serve as Healthmap member advocate, utilize community resources and programs, and serve as liaison between the member, the member&rsquo;s support network, treating physician, and ancillary providers to assist members in meeting individualized goals</li><li>
Accountable for individual and departmental metrics and key performance indicators as identified by the organization</li><li>
Ensure timely and successful delivery of reports to internal and external stakeholders</li><li>
Maintain thorough documentation of all provider meetings/interactions and member interactions for consistency and coordination and in compliance with National Committee for Quality Assurance (NCQA) standards</li><li>
Ensure Healthmap policies and procedures are followed and complies with HIPAA privacy laws and all other federal, state, and local regulations</li><li>
Perform other related duties as assigned</li></ul>
Requirements<ul><li>
Bachelor's degree required</li><li>
Active, unrestricted RN license required</li><li>
Basic Life Support (BLS) certification required for all field roles (within 30 days of hire)</li><li>
3+ years of progressive experience in healthcare services, clinical operations, quality, or care management</li><li>
3 years of experience in care gap closure or care coordination activities, including those in an outpatient or hospital setting preferred</li><li>
Prior experience building and managing relationships with health care providers or patients preferred</li><li>
Proof of valid and unrestricted driver&rsquo;s license required; this position requires regular travel within assigned region to support practices</li><li>
Must reside in one of the assigned states</li></ul><div>
Must comply with organization policies for health screening and immunizations, including but not limited to:</div><ul><li>
Current Tuberculosis (TB) test or current chest X-ray</li><li>
Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza)</li><li>
Participation in annual health and wellness screenings</li></ul>
Skills<ul><li>
Excellent verbal, written and presentation skills</li><li>
Interpersonal skills to develop and maintain strong internal and external relationships</li><li>
Ability to multitask, prioritize, and create solutions in a fast-paced environment</li><li>
Demonstrated leadership skills and ability to create and maintain a positive work environment</li><li>
Strong critical thinking and analytical skills</li><li>
Ability to foster strong employee engagement among the team</li><li>
Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint</li></ul>
Heavy Travel, greater than 50%, across your assigned region.
#LI-HYBRID</div>

RN Clinical Care Manager/Case Manager - Hybrid

Join Healthmap Solutions and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Healthmap Solutions

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RN Clinical Care Manager/Case Manager - Hybrid