In-Home Kidney Disease Care Manager RN

Monogram Health; Macon (GA); On-site; USD 80,000 - 97,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401k with employer match

20 PTO days

7 paid holidays

Floating holiday

Parental leave

Employee assistance program

Wellness and growth resources

Job summary

Monogram Health is seeking an experienced Registered Nurse to join our care management team, focusing on in-home, patient-centered CKD/ESRD care. You will build trust with patients and collaborate with physicians, social workers, and PAs to optimize quality of life.

You will perform in-home visits, monitor vitals, and educate patients and families on disease management, medications, and proactive care decisions, while traveling locally.

Qualifications

• Graduate of a nursing program and RN licensed in the post location.
• BLS certification for Healthcare Providers required.
• Ability to travel locally for in-home visits and field work.
• Strong empathy and communication with patients and families.

Responsibilities

• Develop and adapt care plans with patients and providers.
• Conduct in-home care management visits and execute plans.
• Monitor biometric data and follow protocols.
• Inventory and reconcile medications with pharmacists and prescribers.
• Perform health assessments and patient surveys.
• Educate patients on CKD/ESRD, dialysis, and comorbidities.
• Encourage treatment adherence through regular contact.
• Engage families and social supports in care.
• Serve as primary contact during business hours.
• Educate on medications, conditions, diet, exercise, and lifestyle.
• Discuss proactive care decisions, including Advance Care Plans.
• Obtain vitals and escalate concerns to the provider.
• Onboard patients and assist with transitions.
• Document updates in the care management platform.
• Coordinate transitions with dialysis providers.

Skills

Empathy

Excellent communication

Self-starter

Independence

Team collaboration

Education

Graduate of an accredited School of Nursing

BLS certification for Healthcare Providers

Current RN license in posting state

Tools

Microsoft Office

Job description

Monogram Health is seeking an experienced Registered Nurse to join our care management team, focusing on in-home, patient-centered CKD/ESRD care. You will build trust with patients and collaborate with physicians, social workers, and PAs to optimize quality of life.

You will perform in-home visits, monitor vitals, and educate patients and families on disease management, medications, and proactive care decisions, while traveling locally.