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Strive Health · 5 months ago

RN Care Manager, Transitional Care Management- Mountain Time Zone

United States

Full-time

Remote

Mid Level

$74K/yr - $90K/yr

3+ years exp

Strive Health is dedicated to transforming the kidney care system through coordinated care for patients with kidney disease. The RN Care Manager in Transitional Care Management will serve as a clinical resource, ensuring safe transitions between care settings and improving patient outcomes by crafting personalized care plans and collaborating with interdisciplinary teams.

Health CareInformation TechnologyMedicalmHealth

No H1B

Responsibilities

Works closely with the care team to craft personalized and thorough care plans addressing the clinical and non-clinical needs of each patient

Conducts regular assessments virtually to detect undisclosed medical or social issues and changes in the home environment that could pose risks, promptly referring such matters to the appropriate channels for resolution

Perform proactive outreach to patients and providers following TCM guidelines to evaluate status and address needs

Manages a diverse patient panel, swiftly and accurately evaluating individual needs while adhering to NCQA standards for case management

Communicates updates to the care team and family members, identifying gaps in patient understanding of their health status and delivering tailored education and resources to promote informed decision-making

Acts as a liaison with dialysis facilities, conveying care plan updates to facilitate smooth transitions in care, and maintains accurate program software records

Leverages Strive data platforms to identify trends, anomalies, and areas requiring focus

Provides culturally sensitive care to meet the diverse needs of Strive patients, fostering collaboration and communication among all clinical team members to enhance care provision

Utilizes clinical judgment, analytical skills, regular and predictable attendance, and comprehensive knowledge of case management programs to deliver high-quality care

Participate in quality improvement initiatives and regional interdisciplinary team discussions to enhance care coordination, known as TCM rounds

Qualification

Registered Nurse (RN) licenseCertified Case Manager (CCM)Chronic Kidney Disease (CKD) experienceBLSCPR CertificationElectronic Medical Records (EMR)Microsoft 365 SuitePatient care experienceAnalytical skillsCulturally sensitive careCommunication skills

Required

Associate's degree from accredited school of nursing

Current Registered Nurse (RN) license in the state of practice

3+ years combined of related education, experience, or certification

Current BLS or CPR Certification required

Efficient and reliable transportation, including an active driver's license, allowing for the ability to travel across an assigned region to meet patient needs. Locations may include offices, clinics, and patient homes

Provides in-person patient care which may include standing, sitting, walking, pushing, pulling, and lifting

Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms

Preferred

3+ years experience in nephrology, ER, ICU, Cardiac, or Ambulatory Complex case management nursing

Certified Case Manager (CCM) certification preferred

Proficiency in computer skills including Microsoft 365 Suite (word, outlook, excel) due to working in a hybrid-remote environment

Benefits

Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits.

Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts.

Financial & Retirement Support – Competitive compensation with a performance-based discretionary bonus program, 401k with employer match, and financial wellness resources.

Time Off & Leave – Paid holidays, flexible vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves.

Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend.