About Us
We are a data-driven healthcare organization dedicated to achieving operational excellence. Our mission is to make quality healthcare affordable, enhance patient health, and improve the experience for healthcare providers. Through the use of empathy, artificial intelligence, and predictive analytics, we foster strong connections between patients and providers via our Healthguides™ and a centralized Managed Service Organization. Our physician-led model enables partners to deliver high-quality healthcare with a strong emphasis on positive patient outcomes and value.
Position Overview
In this role, you will work collaboratively with clinical teams to provide comprehensive case management, mainly focusing on patients with complex medical, social, economic, or mental health issues. Your responsibilities will include the assessment, planning, implementation, coordination, monitoring, and evaluation of patient health services. The position is remote, with occasional travel required (10%-15%). Candidates are preferred to be located within 90 minutes of Houston.
Key Responsibilities
- Assess the healthcare and psychosocial needs of patients comprehensively
- Review and refine patient navigator interviews with patients
- Develop, implement, and maintain personalized care plans adhering to internal protocols and accreditation standards
- Provide evidence-based clinical interventions aligned with individualized care plan goals
- Collaborate with patient navigators to manage non-clinical aspects of care, such as scheduling appointments and addressing social determinants of health
- Maintain ongoing outreach to patients, continuously monitoring their data and adjusting care plans as needed
- Work with primary care physicians to create specific escalation plans for managing acute exacerbations of chronic conditions
- Educate patients regarding their conditions and available treatment options
- Advocate for patients and assist them in accessing necessary services and resources
- Follow up on referrals to services or resources
- Ensure timely and accurate documentation in electronic health records as per established protocols
- Utilize evidence-based clinical protocols and guidelines, along with defined quality metrics
Qualifications
- Active Registered Nurse license in good standing
- 3+ years of RN Case Management experience in an outpatient setting
- Certification in Case Management (CCM) is preferred; must be obtained within one year of employment
- Supervisory experience is preferred
- Excellent written and verbal communication skills for empathetic engagement with patients, families, and the interdisciplinary team
- Proficient in computer skills and able to learn various EMR and case management documentation systems
- Ability to meet accreditation and quality standards, including NCQA and HEDIS
- Bilingual in English and Spanish is preferred
Benefits
We prioritize your well-being and professional growth while advancing value-based healthcare:
- Work from Home: Enjoy the flexibility of a fully remote position
- Health Coverage: Comprehensive Medical, Dental, and Vision plans
- Retirement Planning: A 401(k) plan with a 3% employer match
- Life and Disability Insurance: Options available for peace of mind
- Employee Assistance Program (EAP): Support when needed
- Flexible Time Off: Customized time off policies for work-life balance
- Parental Leave: Paid parental leave during family transitions
- Professional Development: Resources for learning and career advancement
Compensation
The base pay range for this role is between $80,000 and $85,000 per year, paid bi-weekly. Final compensation will be based on factors such as skill set, experience, education, location, and certifications.
Commitment to Equal Opportunity Employment
We value diversity, inclusion, and belonging, and are committed to equal opportunity employment practices. Employment decisions are made without regard to race, color, age, sex, sexual orientation, identity, national origin, citizenship, religion, marital status, disability, military or veteran status, pregnancy, childbirth, or any other classification protected by applicable laws. Our management is dedicated to these principles in all aspects of employment.
This role requires adherence to all security policies and procedures to protect patient information and our intellectual property.
Employment Type: Full-Time