Lead, RN Care Manager (TCM) - Pennsylvania

Strive Health

Strive Health

Customer Service
Remote
Posted on Wednesday, September 6, 2023

What We Strive For

Strive Health is built for purpose — to transform a broken kidney care system. We are fundamentally changing the lives of kidney disease patients through early identification, engagement and comprehensive coordinated care. Strive’s model is driven by a high-touch care team that integrates with local providers and spans the entire care journey from chronic kidney disease through end-stage kidney disease, leveraging comparative and predictive data and analytics to identify at-risk patients. Strive Health’s interventions significantly reduce the rate of emergent dialysis crash, cut inpatient utilization and significantly improve patient outcomes and experience. Come join our journey as we create THE destination for top talent in the healthcare community and set a new standard for how kidney care should be done.

Why We’re Worth the Application

  • We Strive for excellence and were recognized as one of America’s Best Startup Employers for 2023 by Forbes, Circle of Excellence, American Society of Transplantation, 2023, Best Places to Work – Denver, Comparably.com, 2022, Best Places to Work – Denver, Built in Colorado, 2022
  • We derive innovation and ideas from through authentic diversity intentionally building a team that represents the populations we serve in partnership with our Employee Resource Groups:
    • Strive Forward - LGBTQ
    • Underrepresented Minorities
    • Women and Allies
  • We care and support our Strivers within and beyond work to feel fully charged and empowered through our generous wellbeing offerings including:
    • Flexible time off
    • Companywide wellbeing days
    • Volunteer time off
    • Leave packages including a sabbatical, parental leave and eight weeks paid for living donor
    • Professional development
    • A dedicated certified financial planner
    • Headspace, Carrot Fertility and Gympass for all Strivers
  • We like to have fun by celebrating our successes as a team through team building, company gatherings, trivia, wellbeing raffles, pajama days, a companywide book club and more.
  • We value tenacity to help us overcome obstacles with grit and determination to deliver compassionate kidney care.

Lead RN Care Manager

Under the direction of the ICM Manager, The Lead RNCM provides direct supervision of the RNCMs in the management of complex CKD and ESRD patients referred into the program. The Lead RNCM helps with training, and chart auditing to ensure NCQA accreditation guidelines are met. This individual assists with efforts to develop, implement, evaluate, redesign, and modify Intensive Case Management practice standards and works closely with the ICM staff in an effort to safely, effectively and efficiently assist patients across and through the continuum of care. This position is a working lead role and will require active complex patient management.

Essential Functions

  • Supervises daily operations of the Intensive RN Case Management staff under the direction of the ICM Manager.
  • Helps conduct employee performance reviews.
  • Monitors and mentors Intensive Case Management staff.
  • Coordinates with ICM staff to ensure safe/effective/efficient plans of care are implemented
  • Helps conduct chart audits per established policy to ensure achievement of NCQA accreditation
  • Ensures training programs address identified needs of ICM staff
  • Assists with forecasting of staffing requirements
  • Collaborates with ICM Manager to ensure effective processes and systems are established and maintained to meet goals.
  • Participates in leadership development.
  • Functions as a resource person for the complex care management processes pertaining to NCQA and CCM efforts.
  • Helps Coordinate daily flow of the ICM team (this includes overseeing PTO requests, assignment coverage, on-call coverage).
  • Assists ICM Manger with mentoring and monitoring of documentation expectations in Care Management technology.
  • Perform comprehensive clinical assessments on complex patients and develop a plan of care per NCQA guidelines with member centric goals that are implemented, evaluated, and closed appropriately upon completion of goals.
  • Recognize barriers to compliance and alterations in patient’s condition in a timely manner.
  • Plan and execute appropriate interventions, evaluate outcomes, and adjust plan as needed.
  • Maintain frequent patient contact as directed my ICM program guidelines.
  • Facilitate completion of patient goals through a multidisciplinary approach of collaboration with the Strive Care Team, external resources, and family members.
  • Advocate for patient, ensuring their optimal well-being, quality of care and attainment of appropriate goals.
  • Manage an appropriate level of patient cases assigned in a timely and accurate manner
  • Participate in process improvement activities
  • Collaborate with all levels of the clinical team to improve processes, communication, and team skills needed to provide the best care to our patients
  • Meet in person with internal and/or external stakeholders to facilitate team and business priorities/opportunities.
  • Serve patients in person and in multiple care settings (e.g., patient home, clinics) in addition to virtual visits.
  • Monthly 5-10% of RN or NP charts will be audited to ensure quality care is being provided to our patients in accordance with our program description. Performance management of clinical staff that are not meeting the quality audit expectations is a critical part of the clinical managers role.

Minimum Qualifications

  • 1 year of supervisory/management experience required.
  • 2 years experience working with NCQA CCM accreditation
  • Graduate of an accredited school of nursing
  • Bachelor's degree in Nursing or related field
  • 4 years nursing experience.
  • 2 years complex care management experience or equivalent experience in healthcare environment required.
  • Current Registered Nurse (RN) license in the state of practice required (position may require licensure in multiple states within a region).
  • Certification by a nationally recognized case/care management organization or agreement to obtain within 3 months of hire
  • Business travel
  • Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms

Preferred Qualifications

  • Excellent communication and interpersonal skills.
  • Current knowledge of CKD/ESRD or Complex CM processes preferred.
  • Use of expert clinical practice, leadership skills, and critical thinking skills to efficiently coordinate and direct patient care among all health care providers while maximizing use of resources is required.
  • The motivation and drive to work independently with minimal supervision to pursue continuous development of self and others are required.
  • Ability to foster principles of participative management by identifying/involving relevant individuals in program-related decisions is required.
  • Ability to apply creative and innovative approaches to help develop and maintain systems that achieve higher levels of multi-disciplinary team performance and desired patient outcomes is needed.
  • Managed/Value-Based Care and payor experience preferred
  • Strong analytical skills

Annual Salary Range: $83,700.00-$101,500.00

Strive Health offers competitive compensation and benefits, including Health insurance, Dental insurance, Vision insurance, 401k Retirement Plan with Employer Match, Life and Accidental Death & Dismemberment insurance, Disability insurance, Health Savings Account, Flexible Spending Account, paid company holidays, in addition to Vacation Time Off. An annual performance bonus, determined by company and individual performance, is available for many roles as aligned to Strive Health guidelines.

Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talentacquisition@strivehealth.com