Renal Clinical Case Manager

This is a fully remote position, open to applicants in Arizona, +4 more states.

📋 Description

• Deliver clinical expertise in the management of IDPN and IPN therapies.

• Oversee internal processes related to therapy approval and authorization.

• Support the clinical components necessary for reimbursement within the Revenue Cycle Management team.

• Serve as a clinical Subject Matter Resource for Renal Dietitians, Nurses, Nephrologists, Account Executives, field personnel, and Revenue Cycle Management staff.

• Engage in Quality Management reviews of existing and proposed processes and enhancements.

• Aid in the development of renal programs to expand the client base for IDPN/IPN and other Parenteral and Enteral Nutrition services.

• Provide clinical support for patients within the designated territory, including routine evaluation and monitoring of patients needing IDPN and IPN nutritional therapies.

• Collaborate with CSR and AE staff to gather monthly lab results and payer-required documentation for active patients.

• Assist Account Executives by reviewing the case queue.

• Prepare forms, documents, and letters/statements of medical necessity for renal centers, dialysis networks, or payors.

• Address insurance denials with Insurance Coordinators and/or Billers/Collectors through telephone consultations or written appeal letters.

• Organize or assist with CEU and Web-Ex CEU seminars.

• Conduct live presentations and educational sessions on IDPN/IPN and other nutritional therapies.

• Execute other assigned responsibilities and special projects.

⛳️ Requirements

• Must reside within the Pacific or Mountain Time Zone: Oregon, Washington State, Idaho, Nevada, or Arizona.

• Bachelor’s degree in Nutrition or a related field.

• Must hold a Registered Dietitian or Licensed Nutritionist credential as mandated by state regulations, with a minimum of two years of experience.

• 1-2 years of hands-on experience in a full-service Dialysis facility.

• Experience in renal nutrition, particularly in CKD 5 Dialysis.

• Required experience in dialysis-related parenteral nutrition support therapies.

• IDPN experience is necessary; IDPN/IPN experience is preferred.

• Capability to work independently and make sound decisions within established medical practices, regulations, and guidelines.

• Proficient computer skills with Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint.

🏝️ Benefits

• Comprehensive compensation and a complete benefits package.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• 401k matching.

• Paid time off (PTO).

• Paid holidays.

• Disability insurance.

• Life insurance.

• Employee assistance program.

• Flexible spending account or health savings account.

• Additional voluntary benefits available.