Intensive RN Case Manager / Complex Case Management **Compact Licensure Required** (Remote Role Supporting ID/UT Patient Base)
Overview
Strive Health
Strive Health is built for purpose- to transform a broken kidney care system. We are fundamentally changing the lives of kidney disease patients through early identification and engagement, comprehensive coordinated care, and home-first dialysis. Strive's model is driven by a high-touch care team that integrates with local providers and spans the entire care journey from CKD through ESRD, leveraging comparative and predictive data and analytics to identify patients at risk. Strive Health's interventions significantly reduce the rate of emergent dialysis start, cut inpatient utilization, and significantly improve patient outcomes and experience. Come join our journey as we create THE destination for top ta lent in the Healthcare community and set a new standard for how kidney care should be done.
Intensive RN Case Manager
The Intensive RN Case Manager is primarily responsible for supporting our complex CKD and ESRD patients, who have been referred into the ICM program, in their care journey. This includes building a supportive, professional, and compassionate relationship with our patients, providing appropriate member self-management education on their specific healthcare needs and developing and managing a patient-centered, comprehensive care plan, with the goal of promoting optimal, achievable outcomes for the patient. The Intensive RNCM assists with optimizing patient care across the healthcare continuum and manages the patient closely to help prevent avoidable emergency room visits and hospital admissions. The Intensive RNCM is responsible for collaborating closely with the patient and multidisciplinary teams regarding the patient's condition(s) and ensuring that all care team members are aware of and contribute to the care plan.
Essential Functions
- Perform comprehensive clinical assessments on complex patients and develop a plan of care per NCQA guidelines with member centric goals that are implemented, evaluated, and closed appropriately upon completion of goals
- Recognize barriers to compliance and alterations in patient's condition in a timely manner
- Plan and execute appropriate interventions, evaluate outcomes, and adjust plan as needed
- Maintain frequent patient contact as directed my ICM program guidelines
- Facilitate completion of patient goals through a multidisciplinary approach of collaboration with the Strive Care Team, external resources, and family members
- Advocate for patient, ensuring their optimal well-being, quality of care and attainment of appropriate goals
- Manage an appropriate level of patient cases assigned in a timely and accurate manner
- Act as a resource and provide support to other case management staff by sharing clinical expertise related to pathophysiology and best practices
- Participate in process improvement activities
- Collaborate with all levels of the clinical team to improve processes, communication, and team skills needed to provide the best care to our patients
Qualifications
Minimum Qualifications
- BSN or MSN degree from accredited school of nursing required
- Minimum of 4 years' experience in clinical nursing required
- Minimum of 2 years' experience in complex case management required
- Current Registered Nurse (RN) license in the state of practice required (position may require licensure in multiple states within a region).
- Certification by a nationally recognized case/care management organization or agreement to obtain within 3 months of hire
Preferred Qualifications
- Complex Case Management experience in a Managed Care environment preferred
- Previous experience with CKD and ESRD patients preferred
- Thorough knowledge of the principles and practices of clinical nursing
- Thorough knowledge of the principles and practices of case management
- Thorough knowledge of NCQA Standards
- Working knowledge of care management and coordination
- Working knowledge of evidence-based practice guidelines in the development of care plans
- Ability to utilize clinical judgment, independent analysis, critical thinking skills, time management skills and detailed knowledge of case management program
- Ability to interpret and apply policies and regulations
- Ability to evaluate medical records and other health care data
- Ability to organize work and manage complex priorities
- Ability to work independently and work collaboratively as a member of a team
- Ability to act with skill and compassion in caring for patients with complex needs
Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide and work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications . If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to [email protected]