(Archived) Care Manager RN- Bilingual

Position Requirements

• This position is in-and-around [Tucson]with daily travel to plan member homes in the greater [Tucson] area and adjoining areas

• Desire and ability to drive daily to home visits and engage members and their caregivers with empathy

• Self-starter with the ability to work independently – and at the same time meet company productivity and quality standards

• Ability to create comprehensive care plan for a plan member and manage to specific care goals

• Ability to document in the home, using web-based tools, on a timely basis

• Graduate of an accredited School of Nursing

• Currently licensed as a Registered Nurse in the State of [AZ] (or other NLC state)

• 2+ years previous experience working in care management and/or with CKD/ESRD patients

• Ability to take call remotely on some nights and weekend with Microsoft Office and

mobile phone and web-based clinical documentation systems

Roles and Responsibilities

• Develop and continually adapt an individualized care plan in conjunction with Monogram physicians

• Perform frequent daily in-home care management visits to execute care management plans

• Serve as the primary point of contact and be the first call when members have questions about their health

• Prepare care recommendations and escalations for plan members, write reports regarding the same and communicate the same in weekly internal case rounds

• Understand the needs of Monogram health plan managed care clients and prioritize plan member visits, recommendations and focus accordingly

• Use personal communication skills, patience and diligence to engage plan members and their caregivers

• Perform post-op and hospital discharge visits to help plan members through vulnerable transitions

• Review and document plan member updates and progress in care management platform

• Monitor biometric data and follow approved protocols for any necessary interventions

• Inventory and reconcile medications and coordinate with pharmacists and prescribers

• Perform plan member health assessments and surveys as required

• Deliver individual and group education on CKD, ESRD, dialysis and associated comorbidities

• Encourage medication and treatment adherence through frequent contact with members

• Engage positively with Monogram social workers to facilitate social and behavioral needs to of plan members

• Educate members and facilitate conversations around proactive care decisions, especially relating to transplantation, home modalities and proactive AV fistula placement

• Coordinate with dialysis providers to ensure transitions of care are seamless

Salary and Benefits

Competitive salary and health insurance, dental and vision plan, as well as eligibility for company’s 401(k) plan.