Renal Clinical Case Manager

Pentec Health; Arizona; On-site; USD 72,000 - 90,000; Full time

Benefits offered by this job

medical

dental

vision

401k match

PTO

paid holidays

disability and life insurance

employee assistance

flexible spending or health savings

Job summary

Pentec Health seeks a Renal Clinical Case Manager for full-time remote work in the Pacific/Mountain region. You will provide clinical expertise in IDPN/IPN therapies and coordinate with the Revenue Cycle Management team to support reimbursement and patient care.

The ideal candidate holds a BS in Nutrition with RD or Licensed Nutritionist credentials and 2+ years in dialysis facilities, plus strong MS Office skills to manage documentation and communications.

Qualifications

• BS degree in Nutrition or related field; RD or Licensed Nutritionist as required by state, for at least two years.
• Renal nutrition expertise, CKD 5 dialysis, IDPN/IPN experience preferred.
• Autonomous work style with solid computer skills (Outlook, Word, Excel, PowerPoint).

Responsibilities

• Acts as clinical SME for Renal Dietitians, Nurses, Nephrologists, Account Executives and Revenue Cycle Management staff.
• Coordinates labs and payor documents for active IDPN/IPN patients; reviews queue with AE.
• Prepares forms and letters of medical necessity; escalates denials with payors as needed.
• Organizes CEU and WebEx CEU seminars; conducts educational sessions on IDPN/IPN therapies.

Skills

Renal nutrition experience

Independent decision-making

MS Office proficiency

Education

BS in Nutrition

Registered Dietitian (RD) or Licensed Nutritionist

Tools

Microsoft Office Suite

Job description

Renal Clinical Case Manager

Regular Full-Time Professional Arizona, REMOTE, arizona, AZ, US

2 days ago Requisition ID: 1198

Salary: $72,000.00 Annually

Our Renal Clinical Case Manager provides clinical expertise in management of IDPN and IPN therapies. This role manages internal aspects of therapy approval and authorization and assists with all clinical aspects needed for reimbursement within our Revenue Cycle Management team.

*FOR THIS ROLE YOU MUST BE LOCATED IN PACIFIC OR MOUNTAIN TIME ZONE: OREGON, WASHINGTON STATE, IDAHO, NEVADA AND ARIZONA

• Acts as clinical Subject Matter Resource for Renal Dietitians, Nurses, Nephrologists, Account Executives and/or other field staff as well as Revenue Cycle Management staff. Participates in the Quality Management overview reviewing current and proposed processes and improvements.
• Assists in developing renal program to increase the client base for IDPN/IPN and other forms of Parenteral and Enteral Nutrition (PEN) and related services. Provides Clinical Assistance for all patients within the territory with routine evaluation and monitoring of patients requiring IDPN and IPN nutritional therapies.
• Responsible for coordinating with the CSR and AE to assure monthly labs and payor required documents are obtained for all active patients on therapy and assists AE by reviewing the queue
• Completes all necessary forms, documents and letters/statements of medical necessity as needed by renal centers, dialysis chains or payors. Escalates insurance denials as needed, in conjunction with Insurance Coordinators and/or Billers/Collectors, to payors to obtain approvals for coverage through telephone consultations or via written appeal letters.
• Is available to organize or assist with CEU and Web‑Ex CEU seminars; conduct live displays and educational sessions regarding the use of IDPN/IPN and other nutritional therapies.

*Other job duties and special projects as assigned.

Ideal Candidate Will Have:

• BS degree in Nutrition or equivalent/related field; Must be a Registered Dietitian or Licensed Nutritionist as required by state, for at least two years. 1-2 years of practical experience in a full‑service Dialysis facility.
• Experience in renal nutrition, especially in CKD 5 Dialysis, along with experience in dialysis related parenteral nutrition support therapies is required (IDPN required; IDPN/IPN preferred).
• Able to work autonomously and make independent decisions within generally accepted medical practices, regulations and guidelines.
• Intermediate computer skills with programs such as Microsoft Office Suite: Outlook, Word, Excel and Power Point.

Salary Range:

$72,000.00 Annual

Pentec Health offersa comprehensive compensation and full benefits package.Actual pay will be based on several factors such as qualifications and skills for the role plus geographic location.

• medical
• dental
• vision
• 401k match
• PTO
• paid holidays
• disability and life insurance
• employee assistance
• flexible spending or health savings account
• other additional voluntary benefits