Clinical Care Manager/Case Manager

Responsibilities

• Act as a liaison between Healthmap, provider practices, and members to ensure program engagement and performance
• Develop new provider and partner business relationships to improve member engagement and manage assigned caseloads
• Identify opportunities to improve health outcomes based on provider-specific data
• Provide education on kidney health, Chronic Kidney Disease, ESRD, and renal replacement therapies to providers and members
• Partner with physicians to identify members benefiting from Care Navigation and conduct outreach
• Serve as a member advocate, utilizing community resources to assist members in meeting individualized goals
• Maintain thorough documentation of all interactions in compliance with NCQA standards and HIPAA regulations
• Manage individual and departmental metrics and key performance indicators

Requirements

• Bachelor’s degree required; or 6+ years of RN experience including 3+ years in case management
• Active, unrestricted RN license
• Basic Life Support (BLS) certification (required within 30 days of hire)
• 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management
• Valid and unrestricted driver’s license with ability to travel within the assigned region
• Must reside in an assigned state

Preferred Qualifications

• 3 years of experience in care gap closure or care coordination in outpatient or hospital settings
• Prior experience building and managing relationships with healthcare providers or patients
• Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint)

Benefits

• Competitive compensation range: $78,000 - $119,000 (dependent on market and experience)
• Paid Time Off
• Medical, Dental, and Vision insurance
• Short Term and Long Term Disability
• 401K with company match

About the Company

Healthmap Solutions is the future of specialty health management, focusing on progressive diseases with particular expertise in kidney health populations. We use clinical big data and high-powered analytics to power complex specialty health management programs. We are a diverse, growing company committed to being champions for better health for those who need us most.