Nurse Advocate (Bilingual)

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.

This role will be responsible for providing remote health coaching to members at risk for dialysis. This nurse must be bilingual in Spanish and will help members throughout the United States. Some evening hours and travel are required.

Effectively maintain an assigned caseload of up to 100 managed members; which requires the ability to develop and maintain rapport, document effectively, and make appropriate escalations. Obtain and utilize clinical information to develop an individualized member care plan and clinician-centered care plan per NCQA guidelines. Effectively maintain an assigned caseload of up to 200 members requiring claims review, or claims monitoring; which requires the ability to make successful provider outreach as appropriate, document effectively, and make appropriate escalations. Outreach to providers to obtain information and assist with coordination of Care. Provide support and advocacy to members with barriers related to social determinants of health. Provide education and advocacy to members exploring treatment and coverage options for chronic and end-stage disease. Request/receive member PHI and ensure all information is appropriately documented/shared. Identify and share potential methods of increasing member engagement, improved reporting, or program enhancements. Support Integrated Care Nurse and Sr. Director of Member Advocacy with the collection of member level data to support cross-departmental functions. Understand the roles and responsibilities of each department within Renalogic to support company-wide business processes.