Care Manager - Registered Nurse

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.

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.

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. The base salary range for this role is $96,087 to $116,204 and reflects the range of experience and qualifications we may consider. Final compensation will be determined based on geographic location and job-related factors such as experience, skills, education, certifications, and internal compensation considerations. In addition to base salary, this role is eligible for additional compensation, including bonus opportunities and a comprehensive benefits package.

Responsibilities include working closely with patients' medical providers to develop and continually adapt care plan, performing in-home care management visits to execute care management plan, monitoring biometric data and following approved protocols for any necessary interventions, inventorying and reconciling medications and coordinating with pharmacists and prescribers, performing patient health assessments and surveys as required, delivering individual and group education on CKD, ESRD, dialysis and associated comorbidities, encouraging medication and treatment adherence through frequent contact with patients, engaging family and social support groups in the education and care of patients, serving as the primary point of contact and being the first call when patients have questions (business hours), providing education and coaching around medications, medical conditions, diet, exercise, and lifestyle choices, educating patients and facilitating conversations around proactive care decisions, especially relating to Advance Care Plans and ESRD treatment modalities, obtaining vital signs when visiting patient and escalating any concerns to the provider, initiating patient relationships through enrolment and onboarding processes, performing post-op and hospital discharge visits to help patients through vulnerable transitions, reviewing and documenting patient updates and progress in care management platform, and coordinating with dialysis providers to ensure transitions of care are seamless.

Position requirements include 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, and familiarity with Microsoft Office and mobile phone and web-based applications.

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 counseling 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.

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