Nurse Care Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the comprehensive care management of an assigned patient panel utilizing clinical expertise, nursing knowledge, and principles of value-based care.

• Foster trusting relationships with patients and their families, offering clinical and emotional support throughout their healthcare journey.

• Act as a patient advocate and community liaison, ensuring timely access to resources, support, and adherence to personalized treatment plans.

• Execute thorough assessments, including social determinants of health, to determine patient and caregiver needs, goals, and preferences.

• Create and sustain patient-centered care plans informed by continuous assessments and evaluations.

• Organize post-discharge follow-up, medication reconciliation, referrals, and the implementation of care plans.

• Facilitate interdisciplinary care to enhance continuity, minimize fragmentation, and support smooth transitions across various care settings.

• Evaluate the effectiveness of care plans and adjust interventions as necessary to achieve targeted outcomes.

• Adhere to evidence-based guidelines and established workflows to fulfill organizational, regulatory, payer, and quality standards.

• Identify cost-effective interventions and resources that enhance outcomes and promote responsible resource utilization.

• Educate patients and caregivers regarding treatment options, self-management techniques, and available resources.

• Engage in clinical huddles, interdisciplinary care conferences, and discussions about patient care.

• Promote process improvements in care management workflows, patient engagement, transitions of care, and overall patient experience.

• Prepare reports and communications pertaining to program updates, outcomes, and performance metrics.

• Collect, analyze, and report data regarding program performance, patient outcomes, quality measures, and patient/caregiver satisfaction.

• Perform additional duties as assigned, consistent with the responsibilities of the role.

⛳️ Requirements

• Associate Degree in Nursing.

• Current RN license is required; compact license is preferred.

• A minimum of 3 years of experience in care management.

• Experience in managing chronic and complex care is essential.

• At least 2 years of experience in Transitions of Care is preferred.

• Experience in utilization management is preferred.

• Certification as a Case Manager is preferred.

• Proficient in MS Office Suite, including Outlook and Teams.

• Ability to work effectively in a primarily remote setting.

• 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.

• Employees must work from a dedicated area free from ongoing interruptions to protect member PHI / HIPAA information.

• Must be available to work from 8:30 a.m. to 5:00 p.m. CT.

• Must collaborate with physicians, APPs, IDT members, providers, vendors, and community-based services.

🏝️ Benefits

• Eligibility for quarterly bonuses.

• Paid time off starting at 4 weeks for full-time employees.

• 12 paid holidays annually.

• Comprehensive medical, dental, vision, and life insurance, including an HSA with employer matching.

• Reimbursement for continuing medical education for eligible positions.

• A 401(k) plan with Evergreen matching up to 4% of contributions after six months of employment.

• Paid parental leave.

• A comprehensive training and development program that begins with onboarding and continues throughout your career with Evergreen Nephrology.

• Evergreen will provide remote employees with necessary telephony applications and equipment to fulfill their business role requirements.