Apply to Future Opportunities - Remote RN Case Manager (Puerto Rico)

Healthmap Solutions; San Juan (PR); On-site; USD 55,000 - 75,000; Full time

Job summary

Healthmap Solutions in Puerto Rico is seeking a Registered Nurse Care Navigator to manage kidney health cases. You will coordinate the continuum of care, maintain patient care plans, and collaborate with physicians, nurses, and other providers to achieve high-quality outcomes.

The role requires a Puerto Rico RN license, a bachelor's in nursing, and strong communication skills in English and Spanish. You will work with a diverse care team, navigate health data systems, and support patients across

Qualifications

• Bachelor's degree in nursing is required.
• Active, unrestricted Puerto Rico RN license is required with RN College Membership.
• Three years of case management experience preferred.
• Experience with nephrology or cardiology patients is preferred.
• Bilingual fluency in English and Spanish is required.
• Must reside in Puerto Rico.

Responsibilities

• Handle member calls and deliver world-class service.
• Educate on kidney health, dialysis options, and transplantation.
• Coordinate care plans and monitor patient progress.
• Collaborate with physicians, nurses, and other care team members.
• Ensure HIPAA compliance and privacy regulations.
• Navigate care management documentation systems and reporting.
• Support after-hours and different time zones as needed.

Skills

Advocate

Strategic thinking

Effective communication

Adaptability

Education

Bachelor’s degree in nursing

Job description

Position at Healthmap Solutions Puerto Rico

Company Background

Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. Healthmap Solutions uses clinical big data resources and high-powered analytics to power complex specialty health management programs. Healthmap Solutions is a diverse, growing company committed to our clients and our employees. We are champions for better health, for those who need us most.

Position Summary

The Registered Nurse Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective outcomes for patients and focus on the whole patient and care delivery coordination. Managing a set caseload of mixed acuity members, reviewing and/or obtaining member data and entry in HealthMap’s Care Management documentation system, completing member health and social determinants of health screenings, medication reconciliation, creation and maintaining member-centric care plans, updates of identified problems, barriers, interventions, and goals and assistance with ongoing case management. The Care Navigator will collaborate with internal and external (physicians, nurses, and other healthcare personnel) to assure positive patient outcomes and care coordination.

Responsibilities

• Handle in and outbound calls delivering world-class service to our members
• Educate kidney health and related co-morbid conditions as well as optimizing renal replacement therapy by educating members on the types of dialysis and transplant options
• Engage members into HealthMap’s Kidney Health Program
• Follow up with members based on complexity and cadence by policy
• Serve as patient advocate for responding and working to resolve concerns or barriers
• Utilize community resources and programs in care planning
• Serve as liaison between the patient, the patient’s support network, treating physician, and other ancillary providers as a member of an interdisciplinary care team to coordinate care, resolve nursing problems and assist patients in meeting individualized goals
• Notify providers of identified patient needs based on policy
• Comply with HIPAA privacy laws and all other federal, state, and local regulations
• Comply with company-defined operational policies and procedures
• Comply with company security policies
• Accountable for individual metrics and key performance indicators and identified by the organization
• Navigate technical applications - Excel, OneNote, Outlook, and Word
• Support after hours and various time zones based on business need
• Drive patients and families in their own care and to support self-management
• Perform other duties as assigned

Requirements

• Bachelor’s degree in nursing required
• Active, unrestricted Puerto Rico RN license required and RN College Membership
• Prior experience building and managing relationships with health care providers or patients preferred
• Three (3) years of experience in case management preferred
• Experience working with nephrology or cardiology patients preferred
• Experience with Medicare and Medicaid preferred
• Bilingual fluency in English and Spanish
• Must reside in Puerto Rico

Skills

• Advocate and energize a culture of collaboration, positivity, and motivation
• Strategic thinking and planning
• Deliver effective communication – verbal and written
• Succeeds in a challenging environment with changing priorities

Travel

No Travel

Americans with Disability Specifications

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.