Case Manager RN

As a leading provider of outcomes-driven care for individuals and communities living with chronic conditions, Somatus is helping patients across the country enjoy More Healthy Days at Home.  

Care at Somatus goes beyond treatment. Through a whole‑person approach, we deliver outcomes‑driven integrated care and show up #SomatusStrong for our patients and teammates. We partner closely with health plans, health systems, and provider groups to support patients with, or at risk of developing, cardio, kidney, metabolic, or other chronic conditions.  

We hire the brightest and boldest — talent driven by purpose and impact. Since our founding in 2016, our growth trajectory isn’t just a milestone — it’s a signal. Our leadership values culture and leads with intention as we remain dedicated to driving clinical excellence.   

Does this sound like you? Keep reading. 

How We’ll Support You: 
We offer 25+ health, growth, and wealth work perks to help teammates be the best version of themselves, including: 

• Subsidized personal healthcare coverage: Medical, Dental & Vision, plus Wellness programs 

• Paid Time Off: Accrual of 3 weeks’ Vacation (PTO)

• Professional development: CEU and tuition reimbursement 

This position is responsible for ensuring the continuity of care in both the inpatient and outpatient setting utilizing the appropriate resources within the parameters of established contracts and patients’ health plan benefits. Facilitates continuum of patients’ care utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site or telephonically as the need arises.

This is a fully remote role where compact licensure is strongly preferred.

**The schedule for this position includes some evening hours where you will be expected to work until approximately 8pm, based on member availability. For example: 11am-8pm OR a split shift 8am-12pm and then 4pm-8pm**

• Consistently exhibits behavior and communication skills that demonstrate our company's commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
• Prioritizes patient care needs upon initial visit and addresses emerging issues.
• Virtually meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan telephonically.
• Virtually identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings.
• Consults with physician and other team members to ensure that care plan is successfully implemented.
• Coordinates treatment plans with the care team and triages interventions appropriate to the skill set of the team members.
• Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize clinical outcomes.
• Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management.
• Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care.
• Works in coordination with the care team and demonstrates accountability with patient management and outcome.
• Maintains effective communication with the physicians, hospitalists, extended care facilities, patients and families.
• Assist member to maximize benefits according to health plan.
• Participates actively in assigned Care Management Coordination Committee (CMCC) meetings.
• Documents pertinent patient information and Care Management Plan in Electronic Health Record and Care Management Systems as appropriate.
• Coordinates care with larger interdisciplinary team on assigned patient caseload or panel.
• Adheres to departmental policies and procedures.

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Qualifications:

•  Active RN license in current state of residence with the ability to qualify for additional state licenses as requested

•  2+ years of nursing experience in a hospital, acute care, or direct care setting

• Renal, Chronic Kidney Disease or Dialysis Care experience as a main focus of your job

• Computer proficiency utilizing MS Office (Word, Excel, PowerPoint and Outlook), including the ability to type and talk at the same time while navigating a Windows environment

• Access to dedicated workspace from home for in home office set up

• Ability to work schedule listed

• Reside in a location that can receive a high speed internet connection or can leverage existing high-speed internet service

Preferred Qualifications:

• BSN

• Certified Case Manager (CCM)

• Diabetic educator experience

• ICU, Cardiology or Critical Care experience

• Telephonic case management experience

• Experience with discharge planning

• Solid working knowledge of hypertension and/or diabetes