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Care Manager RN

2 months ago

Philadelphia, Pennsylvania, United States Monogram Health Full time
Care Manager RN Job Description

At Monogram Health, we are seeking a highly skilled Care Manager RN to join our team. As a Care Manager RN, you will play a critical role in building trusting relationships with patients, enabling them to experience a high quality of life at home.

Key Responsibilities:

  • Perform in-home care management visits to execute care management plans
  • Monitor biometric data and follow approved protocols for necessary interventions
  • Inventory and reconcile medications and coordinate with pharmacists and prescribers
  • Perform patient health assessments and surveys as required
  • Deliver individual and group education on CKD, ESRD, dialysis, and associated comorbidities
  • Engage family and social support groups in patient education and care
  • Facilitate conversations around proactive care decisions, especially relating to transplantation, home modalities, and proactive AV fistula placement
  • Perform post-op and hospital discharge visits to support patients through vulnerable transitions
  • Review and document patient updates and progress in care management platform
  • Coordinate with dialysis providers to ensure seamless transitions of care

Requirements:

  • Self-starter with ability to work independently with minimal supervision
  • Graduate of an accredited School of Nursing
  • 2+ years previous experience working in care management and/or with CKD/ESRD patients
  • Ability to take call remotely on some nights and weekends
  • Excellent verbal communication skills in person and on the phone
  • Familiarity with Microsoft Office and mobile phone and web-based applications

Benefits:

  • Comprehensive medical, dental, vision, and life insurance
  • Flexible paid leave and vacation policy

About Monogram Health:

Monogram Health is a value-based chronic condition organization serving patients with chronic kidney and end-stage renal disease and their related metabolic disorders. We are committed to transforming the way nephrology, primary care, and chronic condition treatment is delivered, increasing access to evidence-based care pathways, and addressing social determinants of health.