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Fresenius Medical Care North America CKD Complex Case Manager in Austin, Texas

Job ID 21000G5P

Available Openings 1

PURPOSE AND SCOPE:

Promotes quality member care, ongoing customer support and care coordination for our renal member population by providing guidance, support, coordination, education and other care coordination functions as defined by the pertinent program. Implements the pertinent program as assigned while acting as the subject matter expert and resource for members, colleagues, dialysis staff, physicians and other healthcare professionals. Services are generally provided telephonically.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Utilizes nursing knowledge and clinical judgement, independent data analysis, critical thinking, time management skills, review of medical information, collaboration with clinical and non-clinical members of the healthcare team, and knowledge of CNU processes to develop and facilitate coordination of care for FHP-assigned and referred members.

  • Collaborate with clinical and non-clinical staff and other members of the patient’s health care team to develop individualized interventions to meet the member’s current needs

  • Communicate and coordinate with the patient as well as appropriate members of patient’s health care team in developing, executing and reviewing results of care coordination efforts

  • Utilizes motivational interviewing techniques to influence members to engage in their own care.

  • Acts within state’s RN Scope of Practice in all situations.

  • Builds collaborative, productive relationships with teammates, members, and other stakeholders.

  • Collaborates with providers and members to ensure optimal and successful transition from chronic kidney disease to dialysis.

  • Collaborates with providers and dialysis clinics to identify and mitigate hospitalization and mortality risk for members.

  • Utilizes good documentation practices to accurately document interactions with members, members’ health records, caregivers, and other stakeholders.

  • Multitasks efficiently to meet multiple task outcomes in a timely manner.

  • Independently manages workload to ensure completion of assigned work and meet productivity expectations.

  • Maintains current and accurate nursing knowledge and best practice guidelines, including specifics regarding chronic kidney disease and end-stage renal disease.

  • Improves job-related capabilities through continuing education, professional seminars, and technical workshops.

  • Participates in quality improvement activities and project-based work including practice, clinic and community-based education initiatives.

  • Participates in meetings to review and provide education on the CNU and other care management interventions.

  • Evaluates program processes and makes recommendations to management that will improve the effectiveness and

  • efficiency of the program.

  • Maintains the integrity of Protected Health Information (PHI).

  • Complies with all departmental required data collection and auditing activities.

  • Escalates issues to supervisor/manager for resolution, as deemed necessary.

  • Reviews and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.

  • Other duties as assigned.

Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.

ADDENDUM:

Addendum for CKD Complex Case Manager

Purpose and Scope :

  • Under the supervision of the Complex Case Management Program Management leadership, the Registered Nurse (RN) Complex Case Manager (CCM) is responsible for assessing and providing case management services to complex patients who participate in the Chronic Kidney Disease (CKD) Program KC:365. The patient population covered will include patients who have CKD along with other significantly complex medical conditions, and/or social-economic factors. The goal of the program will be to assist these patients to achieve optimal health and/or independence in the managing of their care. To achieve this goal the RNCCM will demonstrate and apply knowledge of the philosophy/principles of comprehensive case management, patient-centered, culturally sensitive care coordination, and management of complex patients.

Principle Duties and Responsibilities in addition to duties listed above :

  • Assess the physical, functional, social, psychological, environmental, learning, and financial needs of patients.

  • Identify problems, goals and interventions designed to meet patient’s needs, including prioritized goals that consider the patient goals, preferences, and desired level of involvement in the case management plan.

  • Create care plan including objectives, goals and actions designed to meet patient’s needs.

  • Evaluate patient’s progress toward goal achievement, including identification and evaluation of barriers to meeting or complying with case management plan of care, and systematically reassess for changes in goals and/or health status.

  • Communicates with Nephrologist and Primary Care Physician and members of the comprehensive care team regarding status of the patient.

  • Utilize motivational interviewing skills and effective teach back to build patient engagement in case management plan of care.

Education :

  • Certified Case Manager (CCM) certification preferred.

Experience and Required Skills :

  • 2 years of Case Management experience required.

  • Complex Case Management experience preferred.

  • Case Management Certification strongly preferred.

  • If staff member does not have CCM certification, recommend CCM certification application submitted within 30 months of hire and maintained during employment.

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.

PHYSICAL DEMANDS AND WORKING CONDITIONS :

  • The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Demands include but are not limited to: being able to sit at a desk for several hours a day which includes telephonic work and/or attending required meetings.

  • Travel and visits to clinics, medical offices, hospitals and/or patient homes may be required

EDUCATION :

  • Registered Nurse (RN) required with active unrestricted licensure in practicing state- with the ability to obtain licensure in multiple states.

  • Bachelor of Science in Nursing (BSN) preferred.

EXPERIENCE AND REQUIRED SKILLS :

  • 2 to 5 years of Nephrology Nursing and/or Case Management experience preferred.

  • Experience in a role related to patient education and/or case management is preferred.

  • Must exhibit leadership skills and be able to collaborate with clinic staff.

  • Must have knowledge of teaching-learning process, principles, and methods of adult education.

  • Understanding of renal and diabetes disease process and current management practices.

  • Excellent written and verbal communication is necessary.

  • Excellent and professional telephone skills.

  • Ability to function as a part of an integrated team.

  • Adequate presentation skills needed to prepare and deliver presentations to small groups telephonically or in-person.

  • Ability to develop positive relationships with patients, families, physicians, staff and other disciplines.

  • Must be self-motivated, organized and work independently.

  • Able to follow oral and written communication as well as communicate information to individuals or groups with varying levels of education.

  • Must exhibit practical computer skills such as e-mail, Word documents and basic Excel spreadsheet skills. PowerPoint skills are preferred. Must be able to type proficiently.

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.

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