Chronic Disease Management-RN at Personify Health

, , United States -

Full Time

Start Date

Immediate

Expiry Date

20 Jun, 26

Salary

38.0

Posted On

22 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Telephonic Coordination, Disease Management, Health Promotion, Care Guidelines, Claims Processing Tools, Care Plan Creation, Case Management Referrals, Documentation, Privacy Maintenance, Productivity Tracking, Quality Assurance, Communication Skills, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, Microsoft Outlook

Industry

Health and Human Services

Description

Overview Who We Are Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future. Responsibilities What makes this role different As a Full-Time Disease Management Nurse, you will telephonically coordinate wellness and disease management, with a primary focus on conditions such as diabetes, asthma, COPD, CAD, CHF, atrial fibrillation, hypertension, and hyperlipidemia but not limited to this list. What You'll Actually Do Contact targeted member for health promotion and restoration by the use of national care guidelines to compare patient’s current level of care with industry standards. Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health; create an individual care plan for each patient; provide close follow-up with patients actively managed. Work with patients to ensure they have a primary care provider; assist in referrals to specialists if needed; assist in obtaining durable medical equipment, review pricing for high-cost drugs. Evaluate and make referrals for case management, prenatal program or pharmacology review as indicated. Document interventions and patient contact; maintain privacy of member’s records and assist in providing quarterly reports to clients. Track groups of high-risk members and interventions to show overall health improvement within the organization. Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis. Qualifications What You Bring to Our Mission Essential Functions/Responsibilities/Duties Contact targeted member for health promotion and restoration by the use of national care guidelines to compare patient’s current level of care with industry standards. Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health; create an individual care plan for each patient; provide close follow-up with patients actively managed. Work with patients to ensure they have a primary care provider; assist in referrals to specialists if needed; assist in obtaining durable medical equipment, review pricing for high-cost drugs. Evaluate and make referrals for case management, prenatal program or pharmacology review as indicated. Document interventions and patient contact; maintain privacy of member’s records and assist in providing quarterly reports to clients. Track groups of high-risk members and interventions to show overall health improvement within the organization. Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis. Education and Experience Graduation from an accredited RN program and possession of a current United States RN license. May require additional licensing as business needs change. Prior experience in case management, coordinating wellness programs, or an equivalent combination of education and experience. Required Knowledge, Skills, and Abilities Strong written and verbal communication skills Proficient in Microsoft Excel, Word, PowerPoint and Outlook Demonstrate ability to work independently with excellent judgment Excellent interpersonal and communication skills including able to give presentations to groups and individuals as needed. Good time management skills, highly organized. Why You'll Love It Here We believe in total rewards that actually matter—not just competitive packages, but benefits that support how you want to live and work. Your wellbeing comes first: Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!) Mental health support and wellness programs designed by experts who get it Flexible work arrangements that fit your life, not the other way around Financial security that makes sense: Retirement planning support to help you build real wealth for the future Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage Growth without limits: Professional development opportunities and clear career progression paths Mentorship from industry leaders who want to see you succeed Learning budget to invest in skills that matter to your future A culture that energizes: People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable The practical stuff: Competitive base salary that rewards your success PTO policy because rest and recharge time is non-negotiable Benefits effective day one—because you shouldn’t have to wait to be taken care of Ready to create a healthier world while building the career you want? We're ready for you. No candidate will meet every single qualification listed. If your experience looks different but you think you can bring value to this role, we'd love to learn more about you. Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice. In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $31 to $38 per hour. Note that compensation may vary based on location, skills, and experience. This position is eligible for medical, dental, vision, and other benefits. We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing. #WeAreHiring #PersonifyHealth Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.

Responsibilities

The nurse will telephonically coordinate wellness and disease management for conditions like diabetes, asthma, and hypertension, comparing patient care against national guidelines. Key duties include developing individual care plans, assisting patients with provider access and referrals, and documenting all interventions.