Provide proactive care coordination for patients with complex chronic conditions, including chronic kidney disease.
Conduct high-volume outbound patient outreach via text and phone to maintain engagement and compliance.
Support clinical workflow by coordinating referrals, follow-ups, and documenting interactions for billing compliance.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered approach. They are a committed team focused on improving patient outcomes and quality of life, with a culture of innovation and compassion.
You are responsible for supporting care delivery by partnering with Advanced Practice Providers to execute individualized care plans for patients with chronic kidney disease, hypertension, diabetes, and congestive heart failure.
This role focuses on enhancing clinical outcomes, patient engagement, and care coordination through education, remote monitoring, medication management, and longitudinal patient support.
Key responsibilities include visit preparation, care plan execution, disease management education, medication management, quality measure support, and cross-functional collaboration.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered approach. They are a growing company building a healthcare delivery model focused on improving patient outcomes and quality of life, with a robust team and culture that emphasizes innovation and support.
Manage a portfolio of clients, providing clinical support, education, advocacy, and care coordination throughout their healthcare journey.
Conduct clinical intakes, collaborate with internal teams, and ensure smooth transitions across care delivery.
Communicate clearly and compassionately with clients, caregivers, providers, and internal partners.
Private Health Management guides patients and families through serious medical care, acting as an independent advocate to orchestrate the best treatment and support. The company is a mission-driven organization with a team of experts that provides compassionate, high-quality care coordination.
Assess patients' knowledge of late-stage CKD and educate them on treatment options to enable informed decisions.
Coordinate care and act as a liaison to ensure patients receive comprehensive information on modalities and vascular access.
Use motivational interviewing techniques and participate in clinical data interpretation to improve CKD care processes.
Interwell Health is a kidney care management company that partners with physicians to reimagine healthcare. The company is mission-driven and values diversity, equity, and inclusion, with a collaborative culture focused on helping patients live their best lives.
You will serve as a critical liaison between patients, providers, care teams, and community resources to ensure continuity of care.
You will create and promote adherence to treatment plans developed by healthcare providers.
You will assess patients' unmet health and social needs and connect them to relevant community resources.
Point C is a national third-party administrator that delivers customized self-funded benefit programs. We are a mission-driven company focused on innovative cost containment strategies and driving down plan costs.
Coordinate comprehensive, person-centered care for clients with complex needs, partnering with healthcare providers and social services.
Assess member needs across physical health, mental health, social supports, and more, and oversee development of care plans.
Utilize evidence-based practices like Motivational Interviewing and Trauma-Informed Care to empower clients and promote wellness.
Vynca provides comprehensive care for individuals with complex needs, with a mission to enable more quality days at home. They describe themselves as a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity.