Registered Nurse, Value-Based Care Mgmt - Albuquerque - U.S. Renal Care

The Value-Based Care Management Registered Nurse telephonically interacts with chronic kidney disease patients, families, and support networks to provide comprehensive assistance in all areas related to ongoing education, medical history, medications, development of support systems, lifestyle changes and behavior modifications, thereby reducing future medical costs with early identification and support for dialysis and transplant needs.

Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.

• Responsible for the Value Base Care clinical operations activities across the continuum of care from assessing, implementing, coordinating, monitoring, and evaluating.
• Provides health education, coaching and treatment decision support for patients.
• Collaborates with patient, patient support, and interdisciplinary team members in assessing patient's needs.
• Conducts outbound calls to assess patients' current health status, identifying gaps or barriers in treatment plans.
• Coordinates with and provides consultation with physicians and other health care professionals to support the quality and the level of care provided for patients affected by Chronic Kidney Disease/ End Stage Kidney Disease.
• Assists with early identification and support for dialysis and transplant needs by working closely with the Nephrologist and ETC Team.
• Provides patient education to assist with self-management.
• Knowledge of and comply with federal, state, local laws, and regulations, including health care professionals practice act requirements.
• Performs duties at all times within limitations established by and in accordance with company policy and procedures, applicable state and federal laws and regulations.
• Actively promotes GUEST customer service standards; develops effective relationships at all levels of the organization.
• Participates in team concepts and promote a team effort; performs duties in accordance with company policies and procedures.
• Regular and reliable attendance is required for the job.