RN Care Navigator

4 weeks ago


Pittsburgh, United States HealthMap Solutions LLC Full time

Description Position at Healthmap Solutions Company BackgroundHealthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. Healthmap Solutions uses clinical big data resources and high-powered analytics to power complex specialty health management programs. Healthmap Solutions is a diverse, growing company committed to our clients and our employees. We are champions for better health, for those who need us most. Position SummaryThe Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective outcomes for patients and focus on the whole patient and care delivery coordination. Managing a set caseload of mixed acuity members, reviewing and/or obtaining member data and entry in HealthMap's Care Management documentation system (Compass), completing member health and social determinants of health screenings, medication reconciliation, creation and maintaining member-centric care plans, updates of identified problems, barriers, interventions, and goals and assistance with ongoing case management. The Care Navigator will collaborate with internal and external (physicians, nurses, and other healthcare personnel) to assure positive patient outcomes and care coordination.ResponsibilitiesHandle in and outbound calls delivering world-class service to our membersEducate kidney health and related co-morbid conditions as well as optimizing renal replacement therapy by educating members on the types of dialysis and transplant optionsEngage members into HealthMap's Kidney Health ProgramFollow up with members based on complexity and cadence by policyServe as patient advocate for responding and working to resolve concerns or barriersUtilize community resources and programs in care planningServe as liaison between the patient, the patient's support network, treating physician, and other ancillary providers as a member of an interdisciplinary care team to coordinate care, resolve nursing problems and assist patients in meeting individualized goalsNotify providers of identified patient needs based on policyComply with HIPAA privacy laws and all other federal, state, and local regulationsComply with company-defined operational policies and proceduresComply with company security policiesAccountable for individual metrics and key performance indicators and identified by the organizationNavigate technical applications - Excel, OneNote, Outlook, and WordSupport after hours and various time zones based on business needDrive patient and families in their own care and to support self-managementRequirementsPA RN licenseBachelor's degree in Nursing requiredThree (3) years of experience in case management preferredExperience in a dialysis center or transplant center preferredExperience with Medicare and Medicaid preferredSkillsAdvocate and energize a culture of collaboration, positivity, and motivationStrategic thinking and planningDeliver effective communication - verbal and writtenSucceed in a challenging environment with changing prioritiesTravelNo Travel#LI-RemoteAmericans with Disability SpecificationsThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.


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