Job Description
About Us
We are a data-driven healthcare organization committed to operational excellence. Our mission is to make quality healthcare affordable, improve patient health, and enhance the experience of healthcare providers. By leveraging empathy, artificial intelligence, and predictive analytics, we create meaningful connections between patients and providers through our Healthguides™ and a centralized Managed Service Organization. Our physician-led approach empowers partners to deliver high-quality healthcare that emphasizes positive outcomes and value for all patients.
Position Overview: RN Case Manager
As an RN Case Manager, you will collaborate with clinical teams to provide comprehensive case management and strengthen the connection between patients and their primary care physicians. Your role will focus on helping patients achieve their highest level of wellness, particularly those with complex medical conditions and associated social, economic, or mental health challenges. You will be responsible for optimizing patient health through assessment, planning, implementation, coordination, monitoring, and evaluation of available services. Working closely with a team of patient care navigators and other healthcare professionals, you will strive for optimal quality, clinical, and financial outcomes for your patient population.
This is a remote position, with occasional travel required (10%-15%). We are currently seeking candidates who live or plan to live within 90 minutes of Houston. Thank you for your understanding.
What You'll Do
Assess the healthcare and psychosocial needs of patients comprehensively.
Review and refine patient navigator interviews with patients.
Develop, implement, and maintain personalized care plans that adhere to internal protocols and accreditation standards.
Provide evidence-based clinical interventions aligned with individualized care plan goals.
Collaborate with patient navigators to manage non-clinical aspects of care, such as scheduling appointments, arranging transportation, and addressing social determinants of health.
Maintain ongoing outreach to patients, continuously monitoring their data and adjusting care plans as needed.
Work with primary care physicians to create specific escalation plans for managing acute but non-emergent exacerbations of chronic conditions.
Educate patients about their conditions and available treatment options.
Advocate for patients and assist them in accessing necessary services and resources.
Follow up on referrals to services or resources.
Ensure timely and accurate documentation in electronic health records as per established protocols.
Utilize evidence-based clinical protocols and guidelines, along with defined quality metrics.
What You'll Need
Active Registered Nurse license in good standing.
3+ years of RN Case Management experience in an outpatient setting.
Certification in Case Management (CCM) preferred; must obtain within one year of employment.
Supervisory experience preferred.
Excellent written and verbal communication skills to engage empathetically with patients, families, and the interdisciplinary team.
Proficient computer skills and the ability to learn various EMR and case management documentation systems.
Ability to meet accreditation and quality standards, including NCQA and HEDIS.
Preferred Qualifications
Bilingual in English and Spanish.
Benefits
We prioritize your well-being and growth while you work towards advancing value-based healthcare. Our commitments include:
Work from Home: Enjoy the flexibility of a fully remote position, allowing you to focus on your professional and personal needs.
Health Coverage: Comprehensive Medical, Dental, and Vision plans to keep you and your family covered.
Retirement Planning: A 401(k) plan with a 3% employer match on your 6% contribution.
Life and Disability Insurance: Peace of mind with life and disability insurance options for those unexpected moments.
Employee Assistance Program (EAP): Support when you need it most.
Flexible Time Off: Tailored time off policies to help you achieve work-life balance.
Parental Leave: Paid parental leave to support you during family transitions.
Professional Development: Various resources dedicated to your learning and career advancement.
Compensation
The base pay range for this role is between $80,000 and $85,000 per year, paid bi-weekly. Final base pay decisions will consider factors such as skill set, years of relevant experience, education, location, and licensure/certifications.
Commitment to Equal Opportunity Employment
Diversity, inclusion, and belonging are at the heart of our values. We are an equal opportunity employer and are committed to making employment decisions without regard to race, creed, color, age, sex, sexual orientation, identity, national origin, citizenship, religion, marital status, disability, military or veteran status, pregnancy, childbirth, or any other classification protected by applicable laws. Our management is dedicated to upholding this policy in all aspects of employment, including hiring, promotion, and compensation.
This position is responsible for adhering to all security policies and procedures to protect patient information and our intellectual property.
Employment Type: Full-Time
Salary: $ 80,000.00 85,000.00 Per Year
Job Tags
Weekly pay, Full time, Flexible hours,