Care Coordination RN (Path to Supervisor)
Reports To: Nursing Manager
Department: Nursing & Clinical Operations
FLSA Status: Non-Exempt / Exempt (RN)
Target Hire Timeline: Urgent (Within 60 Days)
Career Progression Track: Care Coordination Supervisor (Evaluated at 6-12 months)
Job Summary
The Care Coordination RN is a high-impact clinical role designed to provide immediate operational support for Kidney Specialists of Minnesota's (KSM) expanding Value-Based Care (VBC) initiatives. Reporting directly to the Nursing Manager, this role serves as the primary clinical engine for the newly launched CKD Stage 2-5 Chronic Care Management (CCM) program while providing hands-on support for Renal Care Coordination (RCC) clinical tasks (e.g., CMS Form 2728 validation and chart reviews, dialysis access and dialysis initiation referrals, TCM visits in ESRD).
This position offers a clear career progression pathway into a formal Care Coordination Lead/ Supervisor role as program enrollment scales and restructured RCC workflows stabilize.
Key Responsibilities & Operational Scope
1. Immediate Primary Focus: CCM Program Support & Execution
- Clinical Care Delivery: Partner closely with the Care Manager(s) to drive day-to-day clinical engagement, comprehensive care plan creation, and monthly touchpoints for CKD Stage 2-5 CCM patients.
- Clinical Workflow Delegation: Take direct ownership of clinical CCM workflows, offloading day-to-day program execution from the Nursing Manager.
- Care Team Collaboration: Work in tandem with non-RN Care Managers, serving as a clinical escalation point for complex patient needs, medication reconciliation, and symptom management.
2. Evolving Scope: RCC & Clinical Chart Auditing
- CMS Form 2728 Verification: Apply nephrology and dialysis expertise to review, audit, and track completion of CMS 2728 forms for optimal dialysis starts and regulatory compliance.
- Clinical Chart Reviews: Perform targeted Acumen/Epic chart reviews to audit modality transitions, hospital discharge follow-ups, and specialty referral completions.
- Workflow Refinement: Partner with the Nursing Manager and Systems Operations to provide front-line feedback, helping refine and standardize RCC workflows as they evolve.
3. Clinic Support Duties
- Nursing Capacity Relief: Support day-to-day coverage of RN tasks including referral management, lab review and follow up, prescription enrollments and refills, prior authorizations.
- Clinical Triage & Overflow: Assist with telephone triage when the primary triage nurse team is overwhelmed or understaffed.
4. Leadership Development & Team Mentorship (Path to Supervisor)
- Mentorship & Guidance: Support the onboarding, clinical growth, and daily guidance of Care Managers and clinical support staff.
- Program Leadership Building: Help monitor program metrics and patient enrollment targets, building the operational framework to step into a formal supervisory role within 6 to 12 months.
Qualifications & Requirements
- Education & Licensure: Active Registered Nurse (RN) license with the Board of Nursing in both Minnesota and Wisconsin; BSN preferred.
- Experience: Minimum 2-3 years of clinical nursing experience in nephrology, outpatient dialysis, or clinical care management.
- Knowledge: Familiarity with ESRD documentation (specifically CMS Form 2728), CKD staging, and care plan development.
- Technical Proficiency: Proficient with EMR systems (Acumen / Epic preferred) for chart reviewing and workqueue tracking.