Chronic Condition Manager - RN - Anderson, SC

Marathon Health • Anderson, SC

1d • Onsite

About The Position

Marathon Health is a leading provider of advanced primary care in the U.S., serving 2.5 million eligible patients through approximately 630 employer and union-sponsored clients. Their comprehensive services include advanced primary care, mental health, occupational health, musculoskeletal, and pharmacy services, delivered through 680+ health centers across 41 states, with virtual services accessible in all 50 states. Marathon Health transforms healthcare delivery with a patient-first approach, prioritizing convenient access to both in-person and virtual care, which results in improved health outcomes and significant cost savings. The company is committed to inclusivity and collaboration, fostering a positive work environment, and recruiting exceptional talent. Marathon has been recognized as a five-time Modern Healthcare Best Places to Work in Healthcare winner and a six-time Best in KLAS award winner for employer-sponsored healthcare services. The Chronic Condition Manager role involves facilitating, developing, monitoring, measuring, and reporting on wellness and chronic disease prevention and management programs that complement the Health Center maintained and coordinated by Marathon Health. This position will educate, counsel, and coach patients on how to prevent and/or manage chronic disease in face-to-face, virtual, and/or telephonic formats, as well as in one-on-one and/or group settings. The CCM may also be responsible for developing educational materials and coordinating efforts among all client vendors to provide cohesiveness of services and better engage the client population. These duties are carried out for a specific client at its various locations.

Requirements

• Registered Nurse (RN) or Bachelor’s degree in Nursing (BSN)
• Minimum 3 years’ experience in chronic disease management (Diabetes Care, Cardiac and Pulmonary Rehabilitation, etc.)

Nice To Haves

• Certified Diabetes Care and Education Specialist (CDCES) strongly preferred
• Passionate about transforming the way healthcare is delivered.
• Passionate about the patient experience.
• Desire to improve the quality of care for people.
• Enjoy working in a collaborative team environment where patients come first
• Entrepreneurial spirit and a passion for creating and driving best practices.
• Willingness to go the extra mile for patients.
• Great customer service skills.
• Ability to work autonomously.
• Demonstrated competence in multi-tasking
• Excellent critical thinking skills
• Experience leading and developing presentations.
• High energy personal style and aptitude for process-oriented thinking
• Track record of consistent, stable employment along with the ability to work independently and as a part of a team

Responsibilities

• Facilitates chronic condition management and prevention programs, including but not limited to: Diabetes Management, Diabetes Prevention, Hypertension Management, Hyperlipidemia Management, COPD, Asthma, Obesity and Cardiovascular Disease. Programs include clinical, educational, and health coaching components
• Develops individualized interventions designed to improve and maximize health outcomes
• Conducts thorough and objective evaluations of the patients’ status, including psychosocial, physical, financial, and educational needs, prognosis, and past and present treatment course and services
• Identifies and enrolls individuals that qualify for chronic condition management programs
• Establishes supportive and confidential relationships with patients
• Assesses patients’ clinical and educational knowledge of chronic condition, readiness to change behavior and individualizes program/s based on needs
• Collaborates with other members of the healthcare team, such Nurse Practitioners, Physician Assistants, Medical Doctors, Health and Wellness Coaches, to optimize care and solve problems
• Conducts outreach via phone, email and regular mail
• Provides face-to-face, virtual and telephonic lifestyle and behavior-related health coaching in both individual and group settings
• Reviews HRA results, if applicable, and provides education and counseling to patients based on risk factors
• Follows workflow and policy guidelines for documentation in the electronic medical record, including the utilization of predictive modeling and behavior change analytics tools
• Applies critical thinking skills and problem-solving techniques to the condition management process
• Participates in the analysis of available data, review of reports, and strategy for enrollment of members to condition management programs
• Performs in-person, virtual, telephonic, and/or electronic proactive outreach to members that are eligible for disease management programs, as well as to unengaged members
• Utilize Evidence Based Medicine in clinical decision making particularly with medication management, diagnostic and lab testing orders, and providing support/education to patients in making healthy lifestyle & behavioral changes.
• Completes accurate, timely and thorough documentation in EMR system.
• Support the mission, vision, and values of Marathon Health.
• Participate in and complete all mandatory Marathon Health trainings and meetings and comply with organizational policies and procedures.
• Participates in education sessions coordinated by Marathon clients for their respective, eligible patient population
• Coordinates efforts with other vendors (carriers, EAP, etc.) to inform client population of all available resources
• Communicates with Marathon Corporate and/or carrier to provide compliance-related information and necessary documentation
• Directs patients to onsite providers, primary care physicians, and/or specialists, as needed
• Maintains current knowledge of disease processes, available resources, and treatment options appropriate to patient populations.
• Performs other duties as assigned

Benefits

• Free Marathon membership for in person and virtual care
• Employer paid life and disability insurance
• Choice in medical/dental plans
• Vision
• Employer funded HSA
• FSA
• Voluntary illness, accident and hospitalization plans
• Benefits are effective on the first of the month following date of hire.
• Competitive compensation
• 401k match
• Access to financial coaching through our Employee Assistance Program
• Paid time off for vacation, sick leave, and more
• Holiday schedule
• FREE Marathon Health services for you and your family, which provides unlimited, free primary care, routine labs, select prescriptions, vaccinations, and virtual mental health care for you and your family
• Choice of 2 medical plans, 2 dental plans, and vision coverage
• Unlimited free mental health benefits and EAP resources
• Rewards for challenges and healthy lifestyle activities
• Family-building and hormonal health benefits
• Paid parental leave
• Generous PTO or FTO
• Paid Holidays + A Day for What Matters
• Company paid Basic Life and Disability insurance
• Supplemental Life
• Spending Accounts
• 401(k) with employer match and graded vesting
• Continuing Medical Education (CME) for maintaining and strengthening the knowledge, skills, and expertise of our health center teammates, as applicable

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees