Reporting to the Executive Vice President of Operations, this position is responsible for the oversight and management of all Renalogic CKD Case Management Services, providing clinical leadership to all programs involved in the early detection, clinical management and outcomes-related cost containment of chronic kidney disease and ESRD.
•Responsible for directing company’s care management practice and its impact on patient outcomes.
•Responsible for development and presentation of Financial and Clinical Outcomes measures tied to CKD Program interventions for client reporting and Sales presentations.
•Provide clinical direction to nursing staff in the delivery of patient care management.
•Develop and implement CKD Program policy and procedures.
•Provide clinical support across all product lines of company.
•Oversee and implement innovative strategies to streamline process and reporting functions within in-house clinical systems.
•Assist in the sales, marketing, communications and public relations efforts for Renalogic Programs. •Manage new client implementations into the CKD Program.
•Oversee monthly/quarterly/yearly client outcomes reporting for the CKD Program.
•Contribute to the development and implementation of departmental goals and objectives, based on the current Playbook.
•Provide leadership in the development and training, compliance, daily coordination and management of clinical team staff members.
•Collaborate with the sales team in the accurate and timely delivery of the Company’s services on client accounts.
•Effectively manage all departmental client-related and patient-related services and develop and track key departmental metrics for management/client review.
•Partner with IT and Finance to develop and implement financial and clinical outcomes reporting for management/client review.
•Partner with Sales Account Executives on strategic proposals to maximize growth and profitability and optimize customer satisfaction/loyalty.
•Partner with Chief Legal Officer and Director of Compliance to ensure compliance with ACA and regulatory requirements.
•Implement improvements to systems, processes and policies in support of the organizational mission including reporting, business process and information flow and management.
•Work with executive management to provide broad based strategic thought leadership on a variety of business topics.
•Other duties as assigned.
•Consistently demonstrates a tenacity to move forward, passion to succeed and a drive to embrace change positively.
•Experience with Insurance Managed Care
•Must possess a current and active nursing license in good standing with the issuing state.
•Must be a Registered Nurse (BSN Preferred).
•5-10 years leadership experience with progressive responsibility in both Healthcare Operations and Clinical roles.
•Experience with leading a remote telephonic work force preferred.
•Experience in leading a disease management clinical program and developing and reporting clinical and operational outcomes.
•Must possess knowledge and understanding of chronic kidney disease and dialysis care, Medicare regulations, and coordination of benefits.
•Demonstrated ability to create a collaborative practice with all health care providers to encourage and expedite quality patient care along the entire health care continuum, to eliminate fragmentation of care and unnecessary costs.
•Experience with applying for and gaining URAC accreditation preferred.
•Excellent verbal and written communication and interpersonal skills.
•Strong critical thinking, analytical and problem solving skills.
•Familiarity with disease management outcomes reporting industry standards and measures.
•Must have a high level of professionalism and diplomacy.
•Promotes a collaborative team environment with both internal and external stakeholders.
•Ability to establish credibility and be highly confidential.
•Proficient in Microsoft Windows based office applications: Excel, Word, PowerPoint and Outlook.
•Ability to learn new technologies with minimal ramp-up.
•Experience with creating and giving presentations to large audiences.
•Results-oriented with the ability to balance other business considerations.
•Required: Registered Nurse
•Required: Bachelor’s Degree in Nursing
•Preferred: CCM certification
Additional Salary Information: Based on Experience
Renalogic has evolved to become a comprehensive provider of data-driven Chronic Kidney Disease (CKD) care and cost management programs for the self-insured industry.
Under the Renalogic services model, our professional staff provides an end-to-end CKD care and cost management approach, built on the strength and proven effectiveness of our care management expertise and our cost containment programs that are built on our proprietary language.