RN Care Navigator/Case Manager

Accountabilities: Manage an assigned caseload of patients with varying levels of clinical complexity, coordinating care throughout the patient healthcare journey. Conduct inbound and outbound calls to engage members, deliver high-quality support, and encourage participation in specialized kidney health management programs. Perform comprehensive health assessments and screenings, including evaluations of medical needs and social determinants of health. Educate patients about kidney disease, related comorbidities, treatment options, and strategies for managing their health effectively. Provide guidance on renal replacement therapy, including different dialysis options and kidney transplantation, helping patients make informed healthcare decisions. Develop, implement, and regularly update individualized, patient-centered care plans, identifying health concerns, barriers, interventions, and measurable goals. Complete medication reconciliation and maintain accurate patient records and care management documentation. Monitor patient progress and conduct follow-ups according to established clinical guidelines, patient complexity, and program requirements. Act as a patient advocate by identifying and addressing concerns, resolving barriers to care, and connecting members with appropriate support services. Coordinate care with treating physicians, nurses, specialists, ancillary providers, patients, and their support networks as part of an interdisciplinary care team. Identify and communicate patient needs to healthcare providers, ensuring timely follow-up and appropriate clinical interventions. Identify and leverage community resources and assistance programs to support patients' medical, social, and overall well-being. Encourage patients and their families to take an active role in healthcare decisions and develop effective self-management practices. Maintain compliance with HIPAA privacy requirements, applicable federal, state, and local regulations, and internal security and operational policies. Meet individual performance metrics, quality standards, and key performance indicators established by the organization. Use Microsoft Office applications, including Excel, Word, Outlook, and OneNote, alongside clinical documentation and care management systems. Provide occasional after-hours support and accommodate different time zones according to operational needs. Requirements: Active, unrestricted Registered Nurse (RN) license in the United States. Bachelor's degree required. Candidates with at least 6 years of nursing experience, including a minimum of 3 years in case management, may be considered in lieu of a bachelor's degree. At least 3 years of case management experience preferred, with the ability to coordinate care and manage patients with varying levels of clinical complexity. Certified Case Manager (CCM) credential preferred. Previous experience working with patients in nephrology, kidney care, or cardiology is highly desirable. Familiarity with Medicare and Medicaid programs, including patient eligibility, coverage, and healthcare coordination processes, is preferred. Strong clinical knowledge and the ability to educate patients about chronic kidney disease, related comorbidities, treatment pathways, and renal replacement therapy. Experience conducting patient assessments, medication reconciliation, care planning, and ongoing clinical follow-ups. Excellent patient advocacy and care coordination skills, with the ability to identify barriers and develop practical solutions that improve patient outcomes. Strong verbal and written communication skills, including the ability to interact effectively with patients, families, physicians, and multidisciplinary healthcare professionals. Excellent interpersonal skills and the ability to build trusting relationships while encouraging patient engagement and self-management. Strong organizational, analytical, and strategic planning abilities, with the capacity to manage multiple priorities in a dynamic healthcare environment. Adaptability and resilience when working with changing priorities and complex patient needs. Proficiency with Microsoft Office applications, particularly Excel, Word, Outlook, and OneNote, as well as general clinical technology platforms. Ability to work independently in a fully remote environment while maintaining productivity, accountability, and high standards of patient care. Availability to work within Mountain or Pacific time zones, with flexibility to support occasional after-hours requirements. Benefits: Fully remote working arrangement for candidates based in the United States and working within Mountain or Pacific time zones. No routine travel required. Opportunity to contribute to specialized kidney health management and improve outcomes for patients with progressive chronic conditions. Collaborative, interdisciplinary clinical environment involving nurses, physicians, and other healthcare professionals. Opportunity to work with clinical data, advanced analytics, and innovative specialty healthcare management approaches. Meaningful patient advocacy responsibilities, with the ability to make a direct impact on care quality and patient well-being. Supportive and inclusive workplace culture that values collaboration, positivity, and professional development. Opportunity to develop expertise in kidney health, chronic disease management, and coordinated care delivery.