Care Manager RN

1 day ago


Immokalee, Florida, United States Monogram Health Full time
Job Description:

Monogram Health is seeking a skilled Registered Nurse to join our team as a Care Manager RN. As a key member of our integrated Care Team, you will work closely with patients, medical providers, and other healthcare professionals to develop and implement personalized care plans.

The ideal candidate will have a strong background in care management and experience working with patients with chronic kidney and end-stage renal disease. You will be responsible for performing in-home care management visits, monitoring biometric data, and coordinating with pharmacists and prescribers to ensure seamless transitions of care.

We offer a competitive compensation package, including a performance-based bonus program, full benefits, and opportunities for professional growth and development.

Responsibilities:
  • Develop and implement personalized care plans for patients with chronic kidney and end-stage renal disease
  • Perform in-home care management visits to execute care management plans
  • Monitor biometric data and follow approved protocols for any necessary interventions
  • Inventory and reconcile medications and coordinate with pharmacists and prescribers
  • Deliver individual and group education on CKD, ESRD, dialysis, and associated comorbidities
  • Encourage medication and treatment adherence through frequent contact with patients
  • Engage family and social support groups in the education and care of patients
  • Provide education and coaching around medications, medical conditions, diet, exercise, and lifestyle choices
  • Initiate patient relationships through enrollment and onboarding processes
  • Perform post-op and hospital discharge visits to help patients through vulnerable transitions
  • Review and document patient updates and progress in care management platform
Requirements:
  • Frequent local travel to perform in-home visits
  • Infrequent domestic travel may be required, primarily to Brentwood, TN for training
  • Self-starter with the ability to work independently with minimal supervision
  • Ability to show empathy and quickly build relationships with patients and physicians
  • Graduate of an accredited School of Nursing
  • Currently licensed as a Registered Nurse in the State of the posted location
  • 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 both in person and on the phone
  • Familiarity with Microsoft Office and mobile phone and web-based applications


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