Care Manager - Registered Nurse

Monogram Health • Beckley, WV

10h • $80,072 - $96,836 • Onsite

About The Position

Monogram Health is seeking a skilled Registered Nurse to serve as a key member of an integrated Care Team that includes an Advanced Practice Provider and a Social Worker. The Care Manager RN works with a small panel of patients who often have multiple serious diseases, helping them improve their quality of life at home and slow the progression of kidney disease. The role focuses on building trusting relationships, providing personalized care management, and supporting positive health outcomes.

Requirements

• Graduate of an accredited School of Nursing.
• Currently licensed as a Registered Nurse in the state of the posted location.
• At least 2 years of previous experience working in care management and/or with CKD/ESRD patients.
• Basic Life Support (BLS) certification for Healthcare Providers.
• Ability to travel locally frequently to perform in-home visits.
• Ability to take remote call on some nights and weekends.
• Ability to work independently with minimal supervision.
• Empathy and ability to build relationships quickly with patients and physicians.
• Excellent verbal communication skills in person and on the phone.
• Familiarity with Microsoft Office and mobile phone and web-based applications.

Responsibilities

• Work with patients’ medical providers to develop and continually adapt care plans.
• Perform in-home care management visits to carry out care plans.
• Monitor biometric data and follow approved protocols for necessary interventions.
• Inventory and reconcile medications and coordinate with pharmacists and prescribers.
• Perform patient health assessments and surveys as required.
• Provide individual and group education about CKD, ESRD, dialysis, and associated comorbidities.
• Encourage medication and treatment adherence through frequent patient contact.
• Engage patients’ families and social support groups in education and care.
• Serve as the primary point of contact for patients’ questions during business hours.
• Coach and educate patients about medications, medical conditions, diet, exercise, and lifestyle choices.
• Educate patients and facilitate conversations about proactive care decisions, including Advance Care Plans and ESRD treatment modalities.
• Obtain vital signs during patient visits and escalate concerns to the provider.
• Initiate patient relationships through enrollment and onboarding.
• Perform post-operative and hospital-discharge visits to support patients through vulnerable transitions.
• Review and document patient updates and progress in the care management platform.
• Coordinate with dialysis providers to ensure seamless transitions of care.

Benefits

• Medical, dental, and vision insurance.
• Employee assistance program.
• Employer-paid and voluntary life insurance.
• Disability insurance.
• Health and flexible spending accounts.
• Competitive compensation and 401(k) with employer match.
• Financial wellness resources.
• 20 PTO days, 7 paid holidays, and 1 floating day.
• Paid parental leave.
• Work-life assistance resources, physical wellness perks, and mental health support.
• Employee referral program and BenefitHub employee discounts.
• Bonus opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level