clinical transplant coordinator

Consociate Health

<div><b>Job Description:</b><p><br>
Consociate Health, a leading Third-Party Administrator, offers an opportunity to grow and develop your career in an environment that provides a fulfilling workplace for employees, and creates continuous learning and embraces the ideas and diversity of others.
</p><p>As part of our Mission to make Healthcare more accessible and affordable for our clients through innovation solutions and expert consultation, we value the inherent qualities that are foremost in our Mission, Vision, Values- Compassion, Humility and Impact, which allow us all to create authentic relationships with our team and our clients.
</p><p><b>POSITION SUMMARY:</b></p><p>
The Case Manager for Transplant and Dialysis provides comprehensive support for members with specialized health benefits, including travel and care coordination at top medical facilities for serious conditions. This role anticipates and resolves member issues, facilitates next steps, addresses financial barriers and ensures access to quality care. The Case Manager also manages clinical travel operations and participates in after-hours on-call rotations.
</p><p><b>PRINCIPAL DUTIES AND RESPONSIBILITIES:</b></p><ul><li>
Case Management: Manage a caseload of 95+ members, acting as the primary point of contact.</li><li>
Hospital &amp; Transport Coordination: Arrange hospital transfers and emergency medical transport for transplants.</li><li>
Eligibility &amp; Education: Verify member eligibility and educate them on transplant and dialysis benefits.</li><li>
Member Support: Handle high-stress calls, resolve member inquiries and provide guidance on next steps.</li><li>
Referral &amp; Account Management: Process new referrals and proactively research member accounts.</li><li>
Documentation &amp; Communication: Record all interactions and coordinate with various stakeholders.</li><li>
Issue Resolution: Address billing issues, claim denials and travel-related inquiries.</li><li>
Member Education: Provide clear guidance on benefit parameters to ensure high member satisfaction.</li><li>
After-Hours Support: Work independently after hours to resolve urgent issues.</li><li>
Process Improvement: Identify workflow gaps and contribute to process enhancements.</li><li>
Performance &amp; Compliance: Meet established goals in efficiency, call quality and customer satisfaction.</li><li>
Travel Coordination: Execute travel reservations and manage travel-related expenses.</li><li>
Leadership &amp; Support: Cover for the supervisor when unavailable and act as a resource for team members.</li><li>
Training &amp; Development: Assist in developing training materials and onboarding new staff.</li><li>
Scheduling &amp; Coverage: Manage on-call schedules, queue coverage and caseload/referral assignments.</li><li>
Communication Management: Monitor and respond to emails in a timely manner.</li><li>
Policy &amp; Compliance: Review forms, policies, SPD language, scripts and job aids for accuracy.</li><li>
Reporting: Maintain and analyze reports as needed.</li></ul><p><b>
GENERAL EXPECTATIONS:</b></p><ul><li>
Present a positive image of Consociate Health at all times.</li><li>
Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual whether they are a customer or co-worker.</li><li>
Communicate in a clear and concise manner, while also demonstrating receptivity through active listening.</li><li>
Identify and perform work that has not been specifically assigned, as needed.</li><li>
Continuously seek opportunities for improvement and suggest ways in which procedures/systems may be modified to accomplish tasks/goal efficiently and effectively.</li><li>
Demonstrate a teamwork philosophy by working cooperatively with others.</li><li>
Attend required in-service and staff meetings.</li><li>
Seek other educational opportunities directly related to this position.</li><li>
Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups and individuals, employees and applicants.</li><li>
Adhere to established safety standards and utilizes proper techniques to avoid work-related injuries.</li></ul><p><b>
BENEFITS:</b></p><ul><li>
Paid time off</li><li>
Paid Holidays</li><li>
Medical, Dental and Vision Insurance</li><li>
Basic Group Life, Short Term and Long Term Disability</li><li>
Voluntary Life, Critical Illness and Accident Coverage</li><li>
401K Plan: Employees are immediately eligible with a 2% automatic enrollment. Consociate matches up to 4% of an employees' annual salary.</li></ul><br>
<b>
Experience and Skills:</b><p><b>
SERVICE EXPECTATIONS:</b></p><ul><li>
Greet all people in a prompt and courteous manner. Communicate in a warm and courteous manner, making eye contact and speaking in a tone of voice that matches words.</li><li>
Ask customers what they need and strive to exceed their expectations. Offer and provide assistance whether or not the request falls within your specific job duties.</li><li>
Respond to customer requests in a timely manner consistent with Consociate Health's standards and best practices, return calls promptly and keep them informed of delays before they ask.</li><li>
Make decisions based on customer needs, opinions, complaints or suggestions.</li><li>
Take appropriate steps to resolve problems to the customer's satisfaction.</li><li>
Ask customers for their opinions, accepting criticism as an opportunity to improve service.</li><li>
Seek opportunities, provide value-added services, and eliminate tasks that do not serve our customer.</li><li>
Remain aware of products and services provided by Consociate Health.</li><li>
Project a positive, professional image when working.</li></ul><p><b>
KNOWLEDGE, SKILLS AND ABILITY REQUIREMENTS:</b></p><ul><li>
High school diploma, GED, or equivalent.</li><li>
1-3 years of experience in customer service, travel, healthcare or a related field.</li><li>
Ability to work independently and manage information flow.</li><li>
Ability to telecommute or reside in Central Arkansas.</li><li>
Proficiency in Office 365, Adobe and Excel.</li><li>
Must be certified and maintain Medical Travel Professional certification</li><li>
College degree in healthcare, psychology, social work or a related field preferred.</li><li>
5+ years of experience in customer service, travel, healthcare or a related field.</li><li>
Knowledge of medical terminology.</li><li>
Experience working with transplant patients.</li><li>
Ability to perform in high-stress, time-sensitive environments.</li></ul><br>
From: Consociate Health</div>

Case Manager Transplant

MedStar Health

<div>About this Job:
<div><div><div><p><b>
Inpatient Transplant Nephrology APP</b></p></div><p></p><div><p><b><br>
Position Title:</b> Advanced Practice Provider &ndash; Transplant Nephrology (Inpatient)<br>
<b>Department:</b><b> </b>Transplant Nephrology / Abdominal Transplant<br>
<b>Reports To:</b> Chief APP for Adult and Pediatric Transplant Surgery, HPB Surgery, Transplant Nephrology, and Transplant Hepatology</p></div><p></p><div><p><b><br>
Position Summary</b></p></div><p></p><div><p><br>
The Inpatient Transplant Nephrology Advanced Practice Provider (APP) provides comprehensive medical management for kidney and pancreas transplant recipients in the inpatient setting. The APP collaborates with transplant nephrologists, transplant surgery APPs, transplant surgeons, pharmacists, coordinators, and multidisciplinary teams to deliver high-quality care across the peri-transplant continuum including pre-transplant evaluation, immediate post-transplant management, and long-term transplant complications requiring hospitalization.</p></div><p></p><div><p><br>
The APP is responsible for daily clinical management of transplant recipients including immunosuppression management, allograft function monitoring, management of transplant-related complications, and coordination of discharge planning.</p></div><p></p><div><p><b><br>
Key Responsibilities</b></p></div><p></p><div><p><b><br>
Clinical Care</b></p></div><div><ul><li><p>
Perform comprehensive history and physical examinations on transplant recipients admitted to the hospital.</p></li></ul></div><div><ul><li><p>
Manage pre- and post-kidney transplant patients, including deceased and living donor recipients.</p></li></ul></div><div><ul><li><p>
Monitor and interpret allograft function, immunosuppression levels, and transplant-related laboratory results.</p></li></ul></div><div><ul><li><p>
Diagnose and manage:</p></li></ul></div><div><ul><li><p>
Delayed graft function</p></li></ul></div><div><ul><li><p>
Acute kidney injury</p></li></ul></div><div><ul><li><p>
Acute rejection</p></li></ul></div><div><ul><li><p>
Infection in immunocompromised patients</p></li></ul></div><div><ul><li><p>
Fluid and electrolyte disorders</p></li></ul></div><div><ul><li><p>
Hypertension</p></li></ul></div><div><ul><li><p>
Immunosuppressive medication complications</p></li></ul></div><div><ul><li><p>
Order and interpret diagnostic studies including labs, imaging, and biopsies.</p></li></ul></div></div><div><div><ul><li><p>
Adjust immunosuppressive regimens in collaboration with transplant nephrologists.</p></li></ul></div><div><ul><li><p>
Coordinate care for transplant recipients requiring dialysis.</p></li></ul></div><p></p><div><p><b><br>
Rounding and Care Coordination</b></p></div><div><ul><li><p>
Participate in daily multidisciplinary transplant rounds.</p></li></ul></div><div><ul><li><p>
Present patients during transplant rounds and contribute to management planning.</p></li></ul></div><div><ul><li><p>
Coordination of care with MDC teams and help facilitate transitions of care including discharge planning and outpatient follow-up.</p></li></ul></div><div><p><b>
Procedures (if applicable based on ins</b><b>t</b><b>itution)</b></p></div><div><ul><li><p>
Remove dialysis catheters and surgical drains.</p></li></ul></div><div><ul><li><p>
Assist with renal transplant biopsies.</p></li></ul></div><div><ul><li><p>
Manage dialysis access issues.</p></li></ul></div><p></p><div><p><b><br>
Education</b></p></div><div><ul><li><p>
Provide education to patients and families regarding:</p></li></ul></div><div><ul><li><p>
Immunosuppressive medications</p></li></ul></div><div><ul><li><p>
Infection prevention</p></li></ul></div><div><ul><li><p>
Post-transplant care</p></li></ul></div><div><ul><li><p>
Participate in education of residents, fellows, APPs and students rotating on transplant services.</p></li></ul></div><p></p><div><p><b><br>
Quality and Program Development</b></p></div></div><div><div><ul><li><p>
Participate in transplant quality improvement initiatives.</p></li></ul></div><div><ul><li><p>
Contribute to maintaining compliance with transplant regulatory bodies including:</p></li></ul></div><div><ul><li><p>
United Network for Organ Sharing (UNOS)</p></li></ul></div><div><ul><li><p>
Organ Procurement and Transplantation Network (OPTN)</p></li></ul></div><div><ul><li><p>
Centers for Medicare &amp; Medicaid Services (CMS)</p></li></ul></div><p></p><div><p><b><br>
Work Environment</b></p></div><div><ul><li><p>
Inpatient hospital setting within a transplant center</p></li></ul></div><div><ul><li><p>
Collaboration with multidisciplinary transplant teams</p></li></ul></div><div><ul><li><p>
Weekend and holiday rotation may be required</p></li></ul></div><div><ul><li><p>
Call coverage may be required depending on program structure</p></li></ul></div><p></p><div><p><b><br>
Minimum Qualifications</b></p></div><p></p><div><p><b><br>
Education</b></p></div><div><ul><li><p>
Master&rsquo;s or Doctoral degree from accredited program:</p></li></ul></div><div><ul><li><p>
Nurse Practitioner (NP)</p></li></ul></div><div><ul><li><p>
Physician Assistant (PA)</p></li></ul></div><div><p><b>
Certification</b></p></div><div><ul><li><p>
National board certification as NP or PA</p></li></ul></div><div><ul><li><p>
State licensure as Advanced Practice Provider</p></li></ul></div></div><div><div><ul><li><p>
DEA license (if applicable)</p></li></ul></div><div><p><b>
Experience</b></p></div><div><ul><li><p>
2+ years of nephrology, transplant, or critical care experience preferred</p></li></ul></div><div><ul><li><p>
Experience with transplant patient population strongly preferred</p></li></ul></div><p></p><div><p><b><br>
Core Competencies</b></p></div><div><ul><li><p>
Expertise in immunosuppression management</p></li></ul></div><div><ul><li><p>
Strong clinical decision-making in complex patients</p></li></ul></div><div><ul><li><p>
Ability to manage immunocompromised patients with multi-organ complications</p></li></ul></div><div><ul><li><p>
Strong interdisciplinary collaboration</p></li></ul></div><div><ul><li><p>
Excellent communication and patient education skills</p></li></ul></div><div><p><b>
Preferred Qualifications</b></p></div><div><ul><li><p>
Prior experience with kidney or pancreas transplant recipients</p></li></ul></div><div><ul><li><p>
Familiarity with transplant regulatory requirements and transplant metrics</p></li></ul></div><div><ul><li><p>
Experience with inpatient transplant protocols and pathways</p></li></ul></div></div></div><br>
<p></p>
This position has a hiring range of : USD $115,003.00 - USD $165,006.00 /Yr.</div>

Inpatient Nephrology PA

Medical College of Wisconsin

<div><h3 class="jobSectionHeader"><b>Position Summary:</b></h3><p>
The Transplant Service Line at Froedtert and the Medical College of Wisconsin (F&amp;MCW) and the MCW Division of Transplant Surgery are seeking an experienced Advanced Practice Provider (Nurse Practitioner or Physician Assistant) to serve as the APP Manager-Transplant Surgery. This role provides clinical, operational, and strategic leadership for Advanced Practice Providers across the transplant service including Inpatient, Transplant ICU (TICU), consulting services, and ambulatory practices.
</p><p></p><p>The APP Manager partners in a triad leadership model with transplant physician leadership and administrative leaders to advance clinical excellence, program growth, workforce development, and patient safety across multi-organ transplant programs including liver, kidney, and pancreas populations.
</p><p></p><p>In addition to leadership responsibilities, the APP Manager maintains clinical practice within the Transplant Service Line contributing to the care of complex, high-acuity transplant patients.
</p><p></p><h3 class="jobSectionHeader"><b>Position Highlights:</b></h3><ul><li><p>
Lead a high-performing APP team in a nationally recognized transplant program with strong outcomes and an innovative focus.
</p></li><li><p>Practice in a high-acuity environment, including transplant ICU and hospital multi-disciplinary teams.
</p></li><li><p>Directly supervise APPs within the transplant service line, including recruitment, onboarding, training, and performance management.
</p></li><li><p>Foster a culture of professional development, engagement, and retention among APP staff</p></li><li><p>
Serve as a mentor and clinical leader, supporting skill development in transplant-specific competencies</p></li><li><p>
Collaborate closely with transplant surgeons, transplant physicians, intensivists, transplant and medical APPs, and additional members of the service line to enhance the care of adult and pediatric transplant recipients, inclusive of multi-organ transplant recipients and living donors.
</p></li><li><p>Drive clinical quality, operational efficiency, and program growth initiatives.
</p></li><li><p>Engage in academic medicine including education, quality improvement, and research opportunities.
</p></li><li><p>Focus on a patient-centered approach to delivery of care and engage in a climate of inquiry, quality, and safety.
</p></li><li><p>Participate in the academic, research and educational missions of the institution.</p></li></ul><p></p><h3 class="jobSectionHeader"><b>
Schedule:
</b></h3><ul><li><p>Full-time position (1.0 FTE)</p></li><li><p>
Combination of clinical and administrative responsibilities.
</p></li><li><p>Anticipated 70% clinical effort and 30% administrative effort</p></li><li><p>
Includes weekend, overnight, and holiday responsibilities aligned with the service coverage model.
</p></li></ul><p></p><h3 class="jobSectionHeader"><b>Procedure for Candidacy:</b></h3><p>
To submit your application, please click on &ldquo;Apply Now.&rdquo; You will create a candidate profile, and you will be prompted to upload your CV and your cover letter, describing your interest and qualifications. References will be required at an appropriate time in the process. All interactions will remain confidential, and no inquiries will be made without the consent of the applicant. Application review will begin immediately and continue until the position is filled.</p><p></p><p><b>
For inquiries or to learn more, please contact:</b></p><p>
Kate Dillon, Physician &amp; APP Recruiter, Sr.</p><p>
katdillon@mcw.edu</p><p></p><p>
#LI-KD1</p><p></p><h3 class="jobSectionHeader"><b>
Qualifications:</b></h3><p><b>
Preferred Experience: </b>Minimum 3 years of APP experience. Strong preference for transplant, critical care, or surgical inpatient experience.
</p><p></p><p><b>Minimum Requirements:
</b></p><ul><li><p><b>Advanced Practice Nurse: </b>Master&rsquo;s Degree or higher in Nursing from a nationally accredited organization.</p></li><li><p><b>
Physician Assistant: </b>Bachelor&rsquo;s Degree or higher in Physician Assistant Studies from an ARC-PA-accredited organization.</p></li><li><p><b>
Advanced Practice Nurse/ Advanced Practice Nurse Practitioner</b>
</p><ul><li><p>Wisconsin RN License</p></li><li><p>
Wisconsin Advanced Practice Nurse Prescriber License</p></li><li><p>
Certification Requirements:</p><ul><li><p>
American Heart Association Advanced Cardiac Life Support (ACLS)</p></li><li><p>
American Heart Association Basic Life Support (BLS)</p></li><li><p>
Advanced Trauma Life Support (ATLS) required within 6 months of start date</p></li></ul></li><li><p>
DEA registration</p></li><li><p>
Nurse Practitioner Certification from a nationally accredited professional nursing organization</p><ul><li><p>
Acute care nurse practitioner preferred.</p></li><li><p>
Will consider FNP or adult care with 2 or more years' experience on Inpatient service or ICU.
</p></li></ul></li></ul></li><li><p><b>Physician Assistant</b></p><ul><li><p>
Wisconsin Physician Assistant License</p></li><li><p>
Certification by National Commission on Certification of Physician Assistants (NCCPA)
</p></li><li><p>Certification Requirements:</p><ul><li><p>
American Heart Association Advanced Cardiac Life Support (ACLS)</p></li><li><p>
American Heart Association Basic Life Support (BLS)</p></li><li><p>
Advanced Trauma Life Support (ATLS) required within 6 months of start date</p></li></ul></li><li><p>
DEA registration</p></li></ul></li></ul><p></p><p>
Learn about Advanced Practice Providers</p><p>
Learn about Advanced Practice Providers</p><p></p><h3 class="jobSectionHeader"><b>
Medical College of Wisconsin</b></h3><p></p><p>
The Medical College of Wisconsin (MCW) is the state&rsquo;s only private medical school and health sciences graduate school. MCW consists of a School of Medicine with campuses in Milwaukee, Green Bay and Central Wisconsin, a School of Graduate Studies, and a School of Pharmacy. MCW is a major national research center ranking in the top third of U.S. medical schools in NIH funding and is the second largest research institution in Wisconsin. Academic medicine is at the core of everything we do at MCW, bringing together scientists, clinicians, students and community members to solve the most complex challenges in health and society. MCW is a diverse group of thought leaders collaborating to pioneer pathways to a healthier world. Every study we conduct and every patient we see leads to new learning and a continuous cycle of life-changing knowledge and innovation.</p><p></p><p><br>
Approximately 1,780 MCW physicians and approximately 905 advanced practice providers care for more than 484,000 patients of all ages annually at Froedtert Hospital, Zablocki VA Medical Center, Children&rsquo;s Wisconsin, and many other hospitals and clinics throughout eastern Wisconsin, representing more than 5.1 million patient visits annually.</p><p></p><p><br>
The beautiful, safe and modern campus of the Milwaukee Regional Medical Center (MRMC) houses Froedtert Hospital, Children&rsquo;s Wisconsin, Curative Care Network, Versiti Blood Research Institute and the Milwaukee County Behavioral Health Division. These member entities share a common mission of excellence in patient care, medical education, biomedical research and community service.</p><p></p><p><b><br>
Commitment to MCW Values</b></p><p>
All of our endeavors at MCW, from our internal operations to our interactions with our partners, are driven by our shared organizational values: acting in Caring ways &ndash; engaging in Collaborative efforts &ndash; approaching our world with Curiosity &ndash; advancing Inclusive practices &ndash; demonstrating Integrity in all we do &ndash; treating everyone with Respect. We are committed to fostering an inclusive environment that values diversity in backgrounds, experiences and perspectives through merit-based processes, and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world, and we recognize that a healthy and thriving community starts from within. Our values define who we are, what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all, then MCW is the place for you.</p><p></p><p><b><br>
Milwaukee, </b>the largest city in Wisconsin, is located on Lake Michigan&rsquo;s western shore. A metropolitan area with more than 1.6 million people, Milwaukee is an affordable, comfortable place to live, work, and play, big enough to be exciting and uncongested enough to get around easily. Milwaukee&rsquo;s many neighborhoods have incredible charm, accommodating a variety of lifestyles, from high-rise apartments to small farms. Nestled along a magnificent bluff overlooking Lake Michigan, Milwaukee&rsquo;s downtown is home to botanical gardens, lakefront museums, a theater district, the world champion Milwaukee Bucks, the Milwaukee Brewers, bustling nightlife, and award-winning restaurants. The lake and its harbors are skirted by scenic parklands and provide first-class opportunities for recreation, including hiking, cycling, boating, and more. A recent study ranked Milwaukee as the 15th most walkable of the 50 largest US cities. Milwaukee has all the advantages of a large, vibrant city but without the stress or cost.</p><p></p><h3 class="jobSectionHeader"><b>
MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination</b></h3><p></p><p>
The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.</p></div><p></p>

Advanced Practice Provider (NP/PA) Manager - Transplant Surgery

Massachusetts General Hospital

Clinical Pharmacist - Advanced Heart Failure and Cardiac Transplant MGH

Evergreen Nephrology

<div><p><b>Who We Are</b></p>
<p>
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants.</p>
<p>
We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.</p>
<p><b>
Who You Are</b></p>
<p>
You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You're excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change.</p>
<p><b>
Your Role</b></p>
<p>
The Evergreen Chronic Care Management (CCM) Medical Assistant (Care Coordinator) supports proactive care coordination services for patients with complex chronic conditions, including chronic kidney disease (CKD), hypertension, diabetes, cardiovascular disease, and related comorbidities. Working under Evergreen's clinical supervision, the Care Coordinator conducts patient outreach, creates, maintains, and reinforces established care plans, supports documentation compliance, and coordinates communication between patients, providers, and healthcare partners.</p>
<p>
This role is outreach-driven and operationally focused, requiring strong organization, patient communication skills, and the ability to manage a high-volume patient panel. Experience supporting nephrology or CKD patient populations is strongly preferred.</p>
<p>
The program uses SMS as the first-line channel for patient engagement, with phone outreach used when appropriate.</p>
<p>
While this position is <b>fully remote</b>, you must be able to work 8:00am &ndash; 5:00pm in the central time zone.</p>
<p><b>
Role Responsibilities</b></p>
<p>
Some responsibilities may vary based on specific patient programs, but this role's primary duties include the following:</p>
<ul>
<li>Patient Enrollment &amp; Eligibility
<ul><li>Support CCM patient enrollment and onboarding activities.</li>
<li>Verify eligibility based on Evergreen and payer program guidelines.</li>
<li>Ensure patient consent documentation is completed prior to outreach.</li>
<li>Proactively maintain patient engagement regularly.</li>
<li>Identify inactive or non-engaged patients and escalate appropriately.</li>
</ul></li><li>Patient Outreach &amp; Engagement
<ul><li>Conduct text &amp; telephonic outreach to enrolled CCM patients weekly.</li>
<li>Achieve required engagement time standards aligned with Medicare CCM billing requirements.</li>
<li>Support achievement of required engagement time for billing compliance.</li>
<li>Reinforce provider-directed care plans during patient interactions.</li>
<li>Identify barriers to adherence including medication access, transportation, or social needs.</li>
</ul></li><li>Expected activities include:
<ul><li>High-volume outbound patient calling and texting.</li>
<li>Follow-up outreach attempts.</li>
</ul></li><li>Documentation &amp; Billing Compliance
<ul><li>Document patient interactions accurately within the CCM patient management platform and EHR systems.</li>
<li>Track engagement time consistent with Medicare CCM billing requirements.</li>
<li>Maintain audit-ready documentation standards.</li>
<li>Ensure HIPAA and PHI compliance.</li>
</ul></li><li>Patient Care Coordination &amp; Clinical Workflow
<ul><li>Facilitate patient access to their referring provider and clinical staff.</li>
<li>Support care transitions following hospitalizations or ED visits.</li>
<li>Coordinate referrals and follow-up appointments.</li>
<li>Escalate symptom concerns or medication issues to licensed clinical staff.</li>
</ul></li><li>Preferred experience includes:
<ul><li>Chronic kidney disease patient populations.</li>
<li>Dialysis patient coordination.</li>
<li>Medication adherence monitoring.</li>
<li>Kidney transplant or specialty referrals.</li>
</ul></li><li>Technology &amp; Communication
<ul><li>Utilize CCM platform and EHR systems daily.</li>
<li>Manage patient messaging workflows.</li>
<li>Collaborate with remote clinical and operational teams.</li>
</ul>
</li></ul><p><b>Required Qualifications</b></p>
<ul>
<li>Certified Medical Assistant</li>
<li>1&ndash;3 years healthcare experience</li>
<li>Chronic disease or nephrology experience is preferred.</li>
<li>Strong clinical assessment, communication, and documentation skills.</li>
<li>Comfortable working in two systems (EHR + CCM platform) simultaneously.</li>
<li>Ability to manage a structured, metric-driven workflow with reliability.</li>
<li>Intermediate skills with MS Office Suite of products including Outlook and Teams</li>
<li>Able to work effectively in a primarily remote environment:
<ul><li>Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended</li>
<li>Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role</li>
<li>Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information</li>
</ul>
</li></ul><p><b>Preferred Qualifications</b></p>
<ul>
<li>Experience in chronic disease management</li>
<li>Prior work in virtual care, remote nursing, or telehealth programs.</li>
<li>Familiarity with CCM regulatory requirements.</li>
<li>Strong patient education and motivational interviewing skills.</li>
</ul>
<p><b>Compensation</b></p>
<p>
The pay range for this role is <b>$45,000 to $52,000 </b>annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.</p>
<p>
This role is also eligible for a bonus.</p>
<p><b>
Benefits
</b></p><p>Evergreen Nephrology's total rewards program is designed to support you in and outside of work. You can expect:</p>
<ul>
<li>Paid time off starting at 4 weeks for full-time employees</li>
<li>12 paid holidays per year</li>
<li>Medical, dental, vision and life insurance, including an HSA with employer match</li>
<li>Reimbursement for continuing medical education for eligible roles</li>
<li>A 401(k) program where Evergreen matches up to 4% of contributions after six months of tenure</li>
<li>Paid parental leave</li>
<li>A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology</li></ul><br>
<p></p>
<p>
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.</p><br>
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If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.</p></div>

Care Coordinator, MA - CST

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p><b>
This is a remote work from home role anywhere in the US with virtual training.</b></p><p></p><p>
American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.</p><p></p><p><b>
Key Responsibilities</b></p><ul><li><p>
This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients.</p></li><li><p>
Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing benefits and/or member&rsquo;s needs to ensure appropriate administration of benefits.</p></li><li><p>
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.</p></li><li><p>
Assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.</p></li><li><p>
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.</p></li><li><p>
Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives.</p></li><li><p>
Utilizes case management processes in compliance with regulatory and company policies and procedures.</p></li><li><p>
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversations.</p></li><li><p>
Identifies and escalates member&rsquo;s needs appropriately following set guidelines and protocols.</p></li><li><p>
Need to actively reach out to members to collaborate/guide their care.</p></li><li><p>
Perform medical necessity reviews.</p></li></ul><p><b><br>
Required Qualifications</b></p><ul><li><p>
5+ years&rsquo; experience as a Registered Nurse with at least 1 year of experience in a hospital setting.</p></li><li><p>
The AHH RN Case manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support.</p></li><li><p>
1+ years&rsquo; experience documenting electronically using a keyboard.</p></li><li><p>
1+ years&rsquo; current or previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/ Obstetrics experience.</p></li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li><p>
1+ years&rsquo; Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience as well as experience with transferring patients to lower levels of care.</p></li><li><p>
1+ years' experience in Utilization Review.</p></li><li><p>
CCM and/or other URAC recognized accreditation preferred.</p></li><li><p>
1+ years&rsquo; experience with MCG, NCCN and/or Lexicomp.</p></li><li><p>
Bilingual in Spanish preferred.</p></li></ul><p><b><br>
Education</b></p><ul><li><p>
Diploma or Associates Degree in Nursing required.</p></li><li><p>
BSN preferred.</p></li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$54,095.00 - $155,538.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Case Manager, Registered Nurse

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