RN Care Ally

** RN, Case Manager
- Nephrology
*** Full-Time, 40 hours per week.
* Monday-Friday;
Business hours between 8:30am-5:00pm.

* Location:

Downers Grove, IL - Position will be mostly remote, with requirements to come to the office for meetings/trainings.  At Duly Health and Care, you are supported to do your best work and make a meaningful impact every day. You will be part of a collaborative, physician-led team that works as one and puts patients at the center of everything we do.
With a connected network of providers, care teams, and services across primary and specialty care, surgery centers, imaging, lab, and therapy, you are part of a system designed to deliver high-quality, coordinated care. Together, we create an environment where you can grow, contribute, and help improve the experience and outcomes for every patient we serve.

** Benefits:*
* • Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance.  
• Access to a mental health benefit at no cost.  
• Employer provided life and disability insurance.  • $5,250 Tuition Reimbursement per year.  
• Immediate 401(k) match.  
• 40 hours paid volunteer time off.  
• A culture committed to community engagement and social impact.  
• Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.  The Nurse Case Manager for Nephrology works in collaboration with physicians, patients and families to promote quality outcomes for patients with complex nephrology conditions. The Case Manager is responsible for increasing efficient utilization of health care services, identifying complex patient cases through the case management process and initiating intensive case management according to program guidelines.

The Case Manager is responsible for managing patients in all health care settings to assure the appropriate level-of-care is provided, to prevent inpatient re-admissions and ensure that the patients' medical, environmental and psychosocial needs are met over the continuum of care. Acting as an advocate, the Nurse Case Manager coordinates care with the health care team, facilitates communication, and supports evidence-based recovery and prevention strategies tailored to nephrology patients.

* Analyze data collected from the predictive modeling tools to identify nephrology patients eligible for the Case Management Program.
* Enroll and manage a case load of patients with complex nephrology conditions, completing case management attestations and initial assessments in accordance with value-based care initiatives.
* Develop individualized care plans with prioritized goals and interventions specific to nephrology patients, ensuring adherence to risk stratification level requirements.
* Collaborate with cardiologists, primary care providers, and multidisciplinary teams to coordinate evidence-based treatment plans and ensure high-quality outcomes.
* Implement strategies to reduce preventable hospitalizations, emergency visits, and readmissions for high-risk nephrology patients.
* Monitor and document clinical progress, patient adherence, and care plan adjustments in accordance with policies and payer requirements.
* Serve as a resource for providers, clinical teams, and staff regarding nephrology-focused case management strategies and bet practices.
* Participate in nephrology-focused quality improvement initiatives and ensure compliance with value-based care metrics.
* Educate patient and families on disease self-management, medication adherence, lifestyle modifications, and available community resources to enhance long-term outcomes.
* Assist with the evaluation and amendment of Case Management Policy and Procedures
* Attend…