Case Manager RN Specialist

1 week ago

Bloomington, Illinois, United States Somatus Full time

Overview of the Role:

Somatus, a leading value-based kidney care company, empowers patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. We are seeking a skilled Case Manager RN Specialist to join our team.

About Somatus:

We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make:

  • Authenticity: We believe in real dialogue, being true to who we are, saying what we mean, and meaning what we say.
  • Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more.
  • Empowerment: We ensure every voice gets heard and all ideas are considered, especially when it comes to our patients' lives or our partners' best interests.
  • Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions.
  • Tenacity: We see challenges as opportunities for growth and improvement - especially when new solutions will make a difference for our patients and partners.

Benefits and Perks:

We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including:

  • Subsidized Healthcare Coverage: Medical, dental, and vision coverage for employees and their families.
  • Accrual of Vacation Time: Three weeks' paid time off (PTO) to recharge and relax.
  • Professional Development Opportunities: CEU, tuition reimbursement, and professional development support to advance your career.
  • Curated Wellness Benefits: Programs supporting physical and mental well-being, including wellness benefits and community engagement opportunities.

About the Job:

This fully remote role requires a skilled Case Manager RN Specialist to ensure continuity of care in both inpatient and outpatient settings. You will facilitate the continuum of patients' care utilizing basic nursing knowledge, experience, and skills to ensure appropriate utilization of resources and patient quality outcomes. The schedule includes some evening hours, where you will be expected to work until approximately 8 pm based on member availability.

Responsibilities:

  1. Exhibit Superior Customer Service: Consistently demonstrate behavior and communication skills that reflect our company's commitment to exceptional customer service.
  2. Prioritize Patient Care Needs: Prioritize patient care needs upon initial visit and address emerging issues.
  3. Meet with Patients and Families: Meet with patients, patients' family members, and caregivers as needed to discuss care and treatment plans.
  4. Identify High-Risk Patients: Identify and assist with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial, and ambulatory settings.
  5. Consult with Physicians: Consult with physicians and other team members to ensure that care plans are successfully implemented.
  6. Coordinate Treatment Plans: Coordinate treatment plans with the care team and triage interventions appropriate to the skill set of the team members.
  7. Use Protocols and Pathways: Utilize established disease management and care management programs and approved by medical management to optimize clinical outcomes.
  8. Monitor and Coach Patients: Monitor and coach patients using techniques of motivational interviewing and behavioral change to maximize self-management.
  9. Oversee Discharge Provisions: Oversee provisions for discharge from facilities, including follow-up appointments, home health, social services, transportation, etc., to maintain continuity of care.
  10. Demonstrate Accountability: Work in coordination with the care team and demonstrate accountability with patient management and outcome.
  11. Maintain Effective Communication: Maintain effective communication with physicians, hospitalists, extended care facilities, patients, and families.
  12. Provide Accurate Information: Provide accurate information to patients and families regarding HMO benefits, community resources, referrals, and other related issues.
  13. Participate in CMCC Meetings: Participate actively in assigned Care Management Coordination Committee (CMCC) meetings.
  14. Document Patient Information: Document pertinent patient information and Care Management Plan in Electronic Health Record and Care Management Systems as appropriate.

Qualifications:

To be successful in this role, you should have:

  • Nursing Education: Graduation from an accredited school of Nursing.
  • Licensure: Compact RN license.
  • Bachelor's Degree: Bachelor's degree in Nursing preferred.
  • Experience: Minimum three years and up to five years of experience in clinical settings demonstrating ability to assess, document, and implement nursing care plans.
  • Past Clinical Experience: Past clinical experience is required.
  • Acute Nursing Experience: Preferred: Three to five years of acute nursing experience in critical care.
  • Care Management Experience: Preferred: Previous care management, utilization review, or discharge planning experience.
  • HMO Experience: Preferred: HMO experience.

Salary Estimate: $65,000-$85,000 per year, depending on experience and qualifications.

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