Care Manager - Registered Nurse

Monogram Health Inc; Holly Springs (MS); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Flexible scheduling

Hybrid work model

Full benefits package

20 PTO days + 7 holidays + floatingday

Job summary

Monogram Health in Mississippi seeks a caring Registered Nurse to join our care management team. You will work with a small panel of patients in-home and through clinic visits to develop and execute individualized care plans for CKD/ESRD, aiming to improve quality of life and slow disease progression.

The role offers a hybrid/in-home schedule, local travel, and a full benefits package. You will educate patients and families, coordinate with physicians, and monitor biometric data, with support

Qualifications

• Must be a graduate of an accredited School of Nursing.
• Currently licensed as a Registered Nurse in the state of the posted location.
• 2+ years experience in care management and/or with CKD/ESRD patients.

Responsibilities

• Develop and adapt care plans with patients’ medical providers.
• Perform in-home care management visits to execute care plans.
• Monitor biometric data and follow protocols for interventions.
• Coordinate with pharmacists and prescribers on medications.
• Educate patients on CKD, ESRD, dialysis and comorbidities.
• Engage families and social support groups in education and care.
• Serve as primary contact during business hours.
• Provide education and coaching on medications, conditions, and lifestyle choices.
• Initiate enrollment and onboarding processes for new patients.
• Review and document patient progress in care management platform.

Skills

BLS Certification

Empathy

Verbal Communication

In-home care management

Travel readiness

Education

Nursing degree

RN License

Tools

Microsoft Office

Job description

Job Description: Care Manager – Registered Nurse

Monogram Health is looking for skilled Registered Nurse eager for the opportunity to make a difference in patients' lives. The Care Manager RN is a key member of an integrated Care Team which includes an Advanced Practice Provider and a Social Worker. The patients we serve often struggle with multiple serious diseases. Registered Nurses help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes.

Your Impact:

As a Registered Nurse, you are an integral part of building trusting relationships with patients, so that they can experience a high quality of life at home. Work with a small panel of patients where you can directly experience the impact of your care. In healthcare systems, the patient has too often become secondary due to processes and incentives that don’t positively impact the patient for the long term. Here at Monogram, we strive to change that narrative by putting our patients and their quality of life at the forefront of what we do.

Highlights & Benefits

• Flexible scheduling with a hybrid and in-home model
• Competitive compensation and a performance-based bonus program
• Full benefits package including medical, dental, vision, life insurance, 401(k) plan with matching contributions, paid vacation and holiday time.
• 20 PTO days, 7 paid holidays, and 1 floating day to make your own.

Roles and Responsibilities

• Work closely with patients’ medical providers to develop and continually adapt care plan
• Perform in-home care management visits to execute care management plan
• Monitor biometric data and follow approved protocols for any necessary interventions
• Inventory and reconcile medications and coordinate with pharmacists and prescribers
• Perform patient health assessments and surveys as required
• Deliver individual and group education on CKD, ESRD, dialysis and associated comorbidities
• Encourage medication and treatment adherence through frequent contact with patients
• Engage family and social support groups in the education and care of patients
• Serve as the primary point of contact and be the first call when patients have questions (business hours)
• Provide education and coaching around medications, medical conditions, diet, exercise, and lifestyle choices
• Educate patients and facilitate conversations around proactive care decisions, especially relating to Advance Care Plans and ESRD treatment modalities
• Obtain vital signs when visiting patient and elevate any concerns to the provider
• Initiate patient relationships through enrolment and onboarding processes
• Perform post-op and hospital discharge visits to help patients through vulnerable transitions
• Review and document patient updates and progress in care management platform
• Coordinate with dialysis providers to ensure transitions of care are seamless

Position Requirements

• Frequent local travel to perform in-home visits
• Basic Life Support (BLS) certification is required in this role. The company will support your certification completion through onboarding
• Infrequent domestic travel may be required, primarily to Brentwood, TN for training
• Self-starter with the ability to work independently with minimal supervision
• Ability to show empathy and quickly build relationships with patients and physicians
• Graduate of an accredited School of Nursing
• Currently licensed as a Registered Nurse in the State of the posted location
• 2+ years previous experience working in care management and/or with CKD/ESRD patients
• Ability to take call remotely on some nights and weekends
• Excellent verbal communication skills both in person and on the phone
• Familiarity with Microsoft Office and mobile phone and web-based applications

About Monogram Health:

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. Monogram Health is based in Nashville, Tennessee, operates throughout 37 states, and is privately held by Frist Cressey Ventures, Norwest Venture Partners, TPG Capital, as well as other leading strategic and financial investors. To learn more about Monogram Health, ranked by Inc. Magazine as 2024’s No. 3 fastest growing private company in the United States, please visit here .

Preferred

Registered Nurse

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.