RN Case Manager; Hybrid

RN Clinical Care Manager/Case Manager (Hybrid)

Apply for the RN Clinical Care Manager/Case Manager (Hybrid) role at Healthmap Solutions
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Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. We use clinical big data resources and high‑powered analytics to power complex specialty health management programs. We are a diverse, growing company committed to our clients and employees, champions for better health for those who need us most.

The Registered Nurse, Clinical Care Manager is responsible for developing and maintaining long‑term relationships with physicians, physician office staff, and Healthmap members engaged in the Kidney Management Program. The role coordinates performance improvement activities and care management to improve health outcomes.

• Act as a liaison between Healthmap, provider practices, and members to ensure positive engagement and program performance.
• Develop new provider/partner relationships to improve engagement and manage assigned caseload.
• Identify opportunities to improve health outcomes for members based on provider data.
• Incorporate education and communication on best practice sharing, process improvement, kidney health interventions, and HEDIS/STAR measures.
• Educate provider offices on chronic kidney disease, end‑stage renal disease, renal replacement therapies, and related topics.
• Partner with physicians to identify members who would benefit from care navigation support, conduct outreach, and engage members in the program.
• Educate members on kidney health, comorbid conditions, and renal replacement therapy.
• Advocate for members, utilize community resources, and liaise with the member’s support network, treating physician, and ancillary providers.
• Accountable for individual and departmental metrics and key performance indicators.
• Ensure timely delivery of reports to internal and external stakeholders.
• Maintain thorough documentation of all provider and member interactions in compliance with NCQA standards.
• Ensure compliance with Healthmap policies, HIPAA privacy laws, and all regulations.
• Perform other related duties as assigned.

• Bachelor’s degree required.
• Active, unrestricted RN license required.
• Basic Life Support (BLS) certification required within 30 days of hire.
• 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management.
• 3 years of care gap closure or care coordination experience, preferably outpatient or hospital settings.
• Prior experience building and managing relationships with healthcare providers or patients preferred.
• Valid, unrestricted driver’s license; regular travel within assigned region required.
• Must reside in one of the assigned states.

• Current tuberculosis (TB) test or chest X‑ray.
• Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID‑19, Influenza).
• Participation in annual health and wellness screenings.

• Excellent verbal, written, and presentation skills.
• Strong interpersonal skills to develop and maintain relationships.
• Ability to multitask, prioritize, and solve problems in a fast‑paced environment.
• Demonstrated leadership and ability to foster a positive work environment.
• Strong critical thinking and analytical skills.
• Employee engagement skills.
• Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint).

Heavy travel (>50%) across the assigned region.

The physical demands described are representative of those that must be met to perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

We do 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. We prohibit discrimination and harassment of any kind.