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RN Care Manager - Transitional Care Management
Strive Health
Original Job Summary
What We Strive For
At Strive Health, we are transforming the kidney care system by early identification, engagement, and comprehensive coordinated care. Our high-touch model uses predictive data to support at-risk patients along their journey. We embrace diversity, celebrate successes, and support each other.
Benefits & Perks
Enjoy hybrid-remote flexibility, comprehensive benefits, financial and retirement support, generous time off, and wellness resources.
What You’ll Do
As an RN Care Manager - Transitional Care Management at Strive Health, you will serve as a specialized clinical resource for patients with complex Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD). You will work closely with interdisciplinary teams to enable safe, effective, and timely transitions using the Coleman Model of transitional care.
- Craft personalized care plans addressing patient clinical and non-clinical needs.
- Conduct virtual assessments to detect changes and risks in patients' home environments.
- Engage in proactive outreach following TCM guidelines to evaluate patient status.
- Manage a diverse patient panel while ensuring NCQA compliance.
- Act as a liaison with dialysis facilities and maintain accurate program software records.
- Participate in quality improvement initiatives and TCM rounds.
- Take part in on-call rotations as required.
Minimum Qualifications
- Associate’s degree in nursing from an accredited school.
- Current Registered Nurse (RN) license in the state of practice.
- 3+ years of related education, experience or certification.
- Current BLS or CPR Certification.
- Reliable internet connectivity.
Preferred Qualifications
- 3+ years of experience in nephrology, ER, ICU, Cardiac, or Ambulatory care.
- Certified Case Manager (CCM) certification is a plus.
- Proficiency with Microsoft 365 Suite in a hybrid-remote environment.
About You
You have a record of developing strong patient and family relationships and are experienced in proactive patient engagement and EMR documentation.
Additional Details
This role includes on-call responsibilities approximately every 6-8 weeks with coverage from Monday to Monday, including evenings and weekends. Regular shifts occur during transitional care hours.
Salary
Annual Salary Range: $74,000.00 - $90,000.00
Equal Opportunity Employer
Strive Health is an equal opportunity employer and a drug free workplace. We do not offer work visa sponsorship. Please apply if you meet the qualifications.
Key skills/competency
- Transitional Care
- Case Management
- CKD
- ESRD
- NCQA Standards
- Patient Engagement
- EMR
- Dialysis Coordination
- Care Coordination
- Hybrid Work
How to Get Hired at Strive Health
🎯 Tips for Getting Hired
- Customize your resume: Highlight transitional care and case management skills.
- Research Strive Health: Understand their care model and mission.
- Emphasize certifications: Include RN license and BLS/CPR details.
- Prepare for interviews: Be ready with clinical scenario responses.
- Show adaptability: Demonstrate remote work skills and EMR proficiency.