Quality Assurance Care Manager

Renalogic is dedicated to helping our clients manage the human and financial costs of chronic kidney disease. To help us in our mission, we hire people who are humble, hungry, and smart. And it sure helps if you have a sense of humor. We're not perfect, but we're trying to build a company that we are all proud of.  Our 96% client retention suggests we're on the right path.   

The individual in this role will deliver effective health coaching support via phone to actively enrolled, newly eligible, and inactive members with chronic kidney disease (CKD) and other comorbidities. Under the direct oversight of Clinical Leadership, additional responsibilities will include but will not be limited to implementing quality improvement measures, supporting the Clinical Care Team, managing projects, collecting and analyzing data, and conducting clinical audits. These tasks will be executed in coordination with Clinical Leadership and other internal teams. 

• Monitor quality improvement initiatives, perform audits, and analyze data to identify opportunities for improvement.
• Ensure the implementation of practices that align clinical standards with NCQA guidelines.
• Identify staff training needs and serve as the primary clinical trainer of newly hired Clinical Care Managers.
• Provide ongoing support and guidance to staff, addressing individual learning needs and fostering skill development.
• Conduct clinical chart audits and collaborate with Clinical Care Managers to gather medical records supporting lab adherence.
• Collect data to monitor and track individual Clinical Care Manager Quarterly Business Objectives (QBOs).
• Identify project needs, define scope, and determine objectives for successful project execution.
• Conduct an annual review of SOP inventory and update SOPs to reflect changes to current workflow processes.
• Collaborate with Clinical Data Analyst to support ad-hoc data delivery requests.
• Lead and support the execution of ImpactInfusion clinical objectives and serve as the subject matter expert for the product.
• Perform comprehensive clinical review of high-cost claimants and serve as the Subject Matter Expert (SME) for the High-Cost Claimant review forum.
• Provide individualized health coaching to a caseload of members as needed.

• Must have an RN license in good standing within a compact state.
  • Nurses will be required to obtain and maintain licensure in good standing in each state where they have members. In order to help with team coverage, nurses may be required to obtain and maintain licensure in any state.
• At least five years of RN experience in a related role.
• Experience with clinical quality or project management highly preferred.
• Be able to work some evenings and/or weekends to assist our members as needed.
• Ability and willingness to travel multiple times a year, which will include overnight stays for corporate gatherings, conferences, and health fairs.
• Ability to attend and professionally engage in video meetings.
• Strong technological skills, meaning you can effectively and efficiently use computers, peripheral equipment, and applications/systems, including Microsoft products.
• Autonomous self-starter who is comfortable with ambiguity.
• Creative mindset and ability to appropriately challenge the status quo.
• Superb written and oral communication skills.
• Ability to overcome obstacles with a ‘yes if...' approach.
• Ability to effectively balance competing deadlines without losing focus on the bigger picture.
• Reliable internet and power with a designated area to conduct work with minimal interruptions.

• Competitive market salary and company stock options.
• Potential for annual merit increases and bonuses contingent on the company's fiscal performance.
• Generous time off and paid holidays because we appreciate recharging.
• Partially paid leave for qualifying family or medical reasons once employment eligibility is met.
• A comprehensive health benefits plan with a portion of premiums covered by the company. Benefits include medical, dental, vision, life insurance, short term disability, long term disability, critical illness, accident, hospital indemnity, identity theft, and pet insurance. Eligibility to participate begins the first of the month following 60 days of employment.
• 401k with up to 4% employer match. Eligibility to participate begins the first of the month following 6 months of employment.

We are proud to be an equal opportunity employer, which means that our employment decisions are inclusive and welcoming, regardless of race, gender, age, color, sexual orientation, gender identity, pregnancy status, religion, national origin, disability, or any other personal, physical, mental, or sensory traits. All individuals who are offered a position must successfully pass a background and reference check prior to their start. All individuals must demonstrate they are legally authorized to work in the United States without sponsorship.