Full-Time Quality Assurance Care Manager

Who We Are 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.

Position Overview 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.

How You'll Contribute

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

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