RN Care Manager, Optimal Starts at Strive Health

Bowling Green, Kentucky, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Jan, 26

Salary

106000.0

Posted On

21 Oct, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Chronic Kidney Disease Management, Patient Education, Care Coordination, Communication Skills, Critical Thinking, Data Analysis, Patient Advocacy, Team Collaboration, Time Management, BLS Certification, Nephrology Knowledge, Transplant Coordination, Patient Activation Measure, Healthcare Delivery, Transportation Skills, Computer Proficiency

Industry

Hospitals and Health Care

Description

What We Strive For At Strive Health, we’re driven by a purpose: transforming the broken kidney care system. Through early identification, engagement, and comprehensive coordinated care, we significantly improve outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization. Our high-touch care model integrates with local providers and uses predictive data to identify and support at-risk patients along their entire care journey. We embrace diversity, celebrate successes, and support each other, making Strive the destination for top talent in healthcare. Join us in making a real difference. Benefits & Perks 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. What You'll Do The Registered Nurse Care Manager, Optimal Starts is responsible for the management of CKD Stage 4/5 patients who are at risk to require kidney replacement therapy (Optimal Starts) by providing education on CKD management and modality options, and by facilitating access placement and a stable transition to kidney replacement therapy. Works alongside Strive nurse practitioners and the nephrology care team to coordinate and facilitate quality, cost-effective care while minimizing fragmentation of the healthcare delivery system for CKD and ESRD patients. Acts as resource for patients and their families, the local care team, and other healthcare professionals. Services to patients may be provided virtually or telephonically, and in-person through on-site visits to clinics, medical offices, hospitals, or patient homes. Essential Functions Collaborates with the nephrology care team to develop an individualized and comprehensive education plan for the patient. Provides education telephonically, virtually, and in-person in clinics, medical offices, hospitals or patient homes. Provides appropriate education, support, and materials to facilitate informed decision making and understanding of chronic kidney disease management and modality options. Provides updates to care team and family members. Identifies patient knowledge and understanding deficits and adjusts the education plan to address. Coordinates referrals to transplant centers and facilitates the completion of the transplant work-up process. Revises and adjusts the patient care plan to reflect educational needs of the patient. Participates in the PAM (Patient Activation Measure) process including, but not limited to, administration of the PAM survey and working with patients on improvement of PAM score. Proactively contacts the patient on a frequent basis as specified in the program details to assess their situation, provide assistance, and answer questions as necessary. Assesses patient conditions, in conjunction with the care team, such as the discovery of unreported medical and social conditions, or changes at home that may lead to adverse outcomes and ensures these concerns are referred to the appropriate sources for attention. Serves as a liaison with dialysis facilities, providing care plan updates to help streamline the transitions in care. Maintains and updates the appropriate program software to manage and record required information and data. Collaborates with Network Engagement and Clinical Leadership teams to prepare for and participate in clinical review meetings with external Nephrology Practice focused on CKD stage 4/5 and ESRD patients. Generates and analyzes reports as needed for management, identifying trends, anomalies and areas of concern. Adheres to company and clinical guidelines to identify, review, assess and allocate patients for program participation according to their identified needs. Participates in process improvement activities. Collaborates with all levels of the clinical team to improve processes, communication, and team skills needed to provide the best care to our patients. Utilizes clinical judgment, independent analysis, critical thinking skills, time management skills and detailed knowledge of case management program. Provides in-person patient care which may include standing, sitting, walking, pushing, pulling, and lifting. Minimum Qualifications Associate’s degree from accredited school of nursing Current state-specific RN licensure to practice, with additional licensure required to meet regional needs 3+ years’ experience in renal nursing. 1+ year experience providing patient education. Current BLS certification required. Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency

Responsibilities

The RN Care Manager is responsible for managing CKD Stage 4/5 patients at risk of requiring kidney replacement therapy by providing education and facilitating access to care. They work alongside the nephrology care team to coordinate quality, cost-effective care while minimizing fragmentation in the healthcare delivery system.