Clinical Care Manager

DescriptionPosition at Healthmap Solutions, Puerto Rico LLCCompany BackgroundHealthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. Healthmap Solutions uses clinical big data resources and high-powered analytics to power complex specialty health management programs. Healthmap Solutions is a diverse, growing company committed to our clients and our employees. We are champions for better health, for those who need us most.Position SummaryThe Clinical Care Manager is responsible for developing and maintaining long-term relationships with physicians, physician office staff, and Healthmap members that are engaged in Healthmap’s Kidney Management Program through coordinating performance improvement activities and care management to improve health outcomes.ResponsibilitiesAct as a liaison between Healthmap, provider practices and Healthmap members to ensure positive engagement and performance with our program(s)Develop new provider/partner business relationships that serve as means to better Healthmap provider and member engagement and manage assigned caseloadIdentify opportunities to improve health outcomes for Healthmap Solutions members based on provider specific dataIncorporate education and communication on Best Practice sharing, process improvement in provider workflows, Kidney Health Management interventions and HEDIS/STAR measures for identified areas of provider low performanceIdentify opportunities to educate provider offices on topics related to Chronic Kidney Disease, End Stage Renal Disease, Renal Replacement Therapies, etc.Partner with physicians/physician staff to identify Healthmap Solutions members that would benefit from Care Navigation support, conduct outreach, and engage members in programEducate Healthmap members on kidney health, related co-morbid conditions, and renal replacement therapyServe as Healthmap member advocate, utilize community resources and programs, and serve as liaison between the member, the member’s support network, treating physician, and ancillary providers to assist members in meeting individualized goalsAccountable for individual and departmental metrics and key performance indicators as identified by the organizationEnsure timely and successful delivery of reports to internal and external stakeholdersMaintain thorough documentation of all provider meetings/interactions and member interactions for consistency and coordination and in compliance with National Committee for Quality Assurance (NCQA) standardsEnsure Healthmap policies and procedures are followed and complies with HIPAA privacy laws and all other federal, state, and local regulationsPerform other related duties as assignedRequirementsAssociate, diploma, or bachelor’s degree in nursing requiredActive, unrestricted RN license requiredBasic Life Support (BLS) certification requiredAdvanced Cardiovascular Life Support (ACLS) certification (based on role)3+ years of progressive experience in healthcare services, clinical operations, quality, or care management3 years of experience in care gap closure or care coordination activities, including those in an outpatient or hospital setting preferredPrior experience building and managing relationships with health care providers or patients preferred-Proof of valid and unrestricted driver’s license required and automobile insurance as required by law; this position requires regular travel within assigned region to support practices and or other healthcare/clinical sites as neededBilingual fluency in English and SpanishOn Island residencyAs applicable, must comply with organization policies for health screening and immunizations, including but not limited to:Current Tuberculosis (TB) test or current chest X-rayProof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza)Participation in annual health and wellness screeningsSkillsExcellent verbal, written and presentation skillsInterpersonal skills to develop and maintain strong internal and external relationshipsAbility to multitask, prioritize, and create solutions in a fast-paced environmentDemonstrated leadership skills and ability to create and maintain a positive work environmentStrong critical thinking and analytical skillsAbility to foster strong employee engagement among the teamMust be proficient in Microsoft Office: Outlook, Word, Excel, PowerPointThis position requires regular travel within assigned region to support practices.Americans with Disability SpecificationsThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.