Coordinates transitions of care for chronic kidney disease members by partnering with hospitals, providers, care navigators, and internal teams. Facilitates discharge handoffs, member identification, provider education, documentation, reporting, and process improvement. Builds healthcare provider relationships, supports quality initiatives, and helps improve care outcomes. Requires an unrestricted RN or LCSW license, healthcare or managed care experience, a valid driver's license, same-state residency, and travel exceeding 50%.
Position Summary:
The Clinical Community Liaison is responsible for serving as the point of contact and coordinator of care hand off with external hospital providers. The Liaison will primarily work to develop a solid approach to identifying and coordinating transition of care for chronic kidney disease members. This position will closely partner with Provider Relation Managers (PRMs,), Quality Practice Advisors (QPAs) and Care Navigation teams to improve the quality of the Kidney Health Management clinical program.
Responsibilities:
- Ability to build positive, productive relationships with care teams, service providers, and coordinators of support
- Collaborate with the assigned hospitals to develop a trusting partnership with clinical providers and interdisciplinary team members
- Interact clearly and professionally with members and their families while gathering additional information related to their kidney health and build bridges to care navigation
- Collaborate with Quality Practice advisors and Care Navigators to facilitate transition of care hand off at time of discharge
- Facilitate the flow of information collaborates with the Care Navigation team to enhance care coordination on Healthmap Solutions members
- Identify members timely and coordinates consent and hand off to care navigation
- Identify opportunities to improve health outcomes for Healthmap Solutions members based on provider specific data
- Incorporate education and communication on Best Practice sharing for identified areas of provider low performance
- Provide assistance post discharge in identifying areas for process improvement in provider office workflows
- Support operational and clinical stakeholders in the identification, development, and execution of process improvement initiatives
- Partner with physicians/physician staff to identify Healthmap Solutions members that would benefit from Care Navigation support
- Function as a resource for and identifies opportunities to educate hospital teams on topics related to Chronic Kidney Disease, End Stage Renal Disease, Renal Replacement Therapies, etc.
- Build strong cross-functional relationships with internal departments and discharge planners
- Maintain thorough documentation of all provider meetings and interactions for consistency and coordination of provider engagement
- Maintain documentation in compliance with National Committee for Quality Assurance (NCQA) standards
- Ensure timely and successful delivery of reports to internal and external stakeholders
- Perform other related duties as assigned
Requirements:
- Bachelor’s degree required; 5+ years of RN or relevant healthcare experience including 3+ years in case management may be considered in lieu of degree
- Active, unrestricted RN or LCSW license required
- 3 years of experience in a health care or managed care setting
- 3 years of experience in claims or gap closure campaigns, preferred
- 3 years of progressive experience in healthcare services, clinical operations, quality, or care management
- Prior experience building and managing relationships with health care providers preferred
- Proof of valid and unrestricted driver’s license required. This position requires travel within assigned region to visit hospital providers
- Same state residency required
- Must be familiar with local healthcare market
Must comply with organization policies for health screening and immunizations, including but not limited to:
- Current Tuberculosis (TB) test or current chest X-ray
- Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza)
- Participation in annual health and wellness screenings
Skills:
- Excellent verbal, written and presentation, skills
- Interpersonal skills to develop and maintain strong internal and external relationships
- Ability to multitask, prioritization, and create solutions in a fast-paced environment
- Strong critical thinking and analytical skills
- Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint
Compensation Range: $110,000 - $130,000 (dependent on specific market/region as well as experience of the candidate selected) plus bonus & potential incentive eligibility
Benefits: Competitive Paid Time Off, Medical, Dental, Vision, Short Term/Long Term Disability, 401K with match and other voluntary benefits as elected.
Benefits: Competitive Paid Time Off, Medical, Dental, Vision, Short Term/Long Term Disability, 401K with match and other voluntary benefits as elected.
Travel:
- Heavy Travel, Over 50%
#LI-Hybrid
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