Nurse Care Manager – Compassionate Care Program

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

📋 Description

• Oversee the healthcare journey of patients referred to the Evergreen Compassionate Care Program, aligning with their healthcare needs, aspirations, and preferences.

• Assume complete responsibility for a designated patient panel, assisting individuals with kidney disease in understanding their diagnosis, prognosis, and available services.

• Collaborate effectively with physicians, advanced practice providers, and members of the interdisciplinary team.

• Conduct assessments and advance care planning, including discussions about goals of care.

• Evaluate patients for hospice suitability and readiness.

• Refer patients to appropriate Evergreen kidney care programs or facilitate ongoing nephrology care.

• Coordinate transitions to hospice care alongside community providers.

• Serve as a clinical liaison and educator for both internal and external partners.

• Foster empathetic relationships with patients and their families.

• Educate patients and families about their diagnosis, prognosis, treatment options, and how to access their preferred treatment.

• Analyze gathered data to uncover opportunities for enhancing symptom management.

• Create, implement, assess, and adjust collaborative care plans.

• Address social determinants of health by leveraging internal resources.

• Engage in huddles, interdisciplinary team meetings, and patient case conferences.

• Coordinate care and access to services across various providers and disciplines.

• Keep accurate patient records and documentation.

• Stay current with knowledge and competencies in hospice and palliative care nursing.

• Educate partners about the ECCP and the criteria for referrals.

• Represent Evergreen Nephrology to patients, families, and the broader community.

• Perform additional duties as assigned that align with the role.

⛳️ Requirements

• Valid RN license in good standing.

• A minimum of 3 years of clinical experience in an intensive care unit, or in hospice or palliative care settings.

• Proven experience in conducting goals of care discussions and making end-of-life care decisions.

• Capability to quickly adapt to shifting priorities in a dynamic startup environment.

• Intermediate proficiency with MS Office Suite, including Outlook and Teams.

• Ability to work efficiently in a remote setting.

• Minimum download speed of 25 Mbps and upload speed of 10 Mbps required.

• Recommended wired internet connection, utilizing Cable, Fiber, or DSL.

• A dedicated workspace free from interruptions to safeguard PHI/HIPAA information.

• CHPN certification is preferred.

• Compact RN licensure is preferred.

• BSN is preferred.

• More than 1 year of utilization management experience is preferred.

🏝️ Benefits

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

• 12 paid holidays annually.

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

• Reimbursement for continuing medical education for eligible positions.

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

• Paid parental leave.

• Comprehensive training and development program from onboarding throughout your career.

• Eligibility for annual bonuses.