We are seeking a highly motivated Clinical Performance Lead to support our clinicians and front-line staff in caring for our members affected by renal disease. As a Clinical Performance Lead, you’ll play a vital role at Monogram Health. We are looking for a proactive individual that can help us continually improve and enhance our clinical performance. The duties and responsibilities of the Clinical Performance Lead include, but are not limited to:
Roles and ResponsibilitiesClinical Interventions – 30%
Review, update, and manage clinical interventions (CI), ad hoc tasking, and messages concerning visits. This may include the following (but not limited to): document CIs, coach and assist RNs on information needed for tasks (develop action plans with RNs concerning moving up visits, outreach to providers, and/or assist with obtaining updated lab work), make calls to members or physicians to complete tasks, review Care Manager documentation for CI, and review Holy Grail for records to complete tasks. Assist APPs with requests, as well as help with SalesForce (coach/ educate on charting in SalesForce or assessments with RN visits, or tasks with CI). Review appropriate sources (Athena or Health Gorilla) for records of our high-risk members/post-discharge members to better inform RNs at visits. Reviews may include missing or updated GFRs/A1c or pulling Nephrology/PCP/Specialty visit notes for CM review with patients at visits. Perform concurrent review hospital calls (such as review hospitalized patients and discharges). Conduct root cause analysis on certain members. Attend leadership meetings, as needed, such as the MPE meeting. Delegate action to the Patient Support Specialist team to request and receive office visit records for review.Patient Care and Treatment – 15%
Review and approve care plans. Discuss patient care with field clinicians (regarding questions or concerns) and provide support and guidance. Also, address clinical escalations from field clinicians too. Facilitate case rounds, PPA clinical rounds, and high-utilizer review, as well as document case rounds follow-up tasks. Execute scheduling needs for high risk, high utilizer members. Perform data analysis, such as data mining for records lab. Address concerns and requests from Pod leadership, such as requests to address a charting concern or coaching for a RN/ NP on SalesForce, and requests to call a member or local providers for various reasons. As needed, speak and document member conversations. Delegate action to the PSS team to request and receive prescriptions and labs for review.Quality Assurance and Compliance – 30%
Delegate action to the PSS team to request and receive labs results for review. Audit medical charts and review missing team visit notes (incomplete documentation). Also, review report and email documentation requests to CMs. Conduct data analysis from various downloaded reports (such as ACP's due, CP's due, CRA assessment due, ACP's completed, BCBS enrolled, outstanding CP's due, and Visits 'in progress'.) and create data spreadsheets. Daily review of documentation and provide guidance on IEs & PHDV. Review and correct care plans to ensure compliance with SLA. Provide Bullet Train care coordination. Provide support to field team for escalations, clinical issues, patient outreach, and RR follow up calls.Training and Communication – 25%
Provide guidance and education on processes, workflows, and documentation to field staff, as well as review current and upcoming MH organizational changes. Attend standard and ad-hoc operational meetings (on a daily, weekly, and/or monthly cadence). Examples of meetings include (but not limited to): weekly Team meetings, daily Pod Leadership meetings, daily CRS meetings, daily PHDV clinician update meetings, daily discharge planning/PHDV scheduling meetings, weekly Pharmacy rounds, weekly NP high-risk rounds, weekly Pod team huddles, weekly Pod Quad meetings, weekly Bullet Train meetings, weekly CC touch base meetings with Scheduling team, monthly Charl. Nephrology case rounds, monthly MH leadership training and meetings, CM/NP huddles and Pod Tear Sheet meetings, 1:1 meetings with staff, APP meeting, CI office hours meeting, CR meeting, HRR meeting, and Client partnership meeting. Prepare slides and content for standard and ad-hoc operational and clinical meetings. Assisting with scheduling needs, Teams chats, emails, and phone calls. Build reports for specific members and their needs. Position Requirements Current, active unrestricted license as a Registered Nurse in assigned states/territories (compact licensing or multi-state licensing may be required). Minimum 2-years of Registered Nurse experience within the last 5 years, or equivalent clinical experience. Demonstrated knowledge and proficiency using technology. Benefits Opportunity to work in a dynamic, fast-paced and innovative value-based provider organization that is transforming delivery of kidney care. Competitive salary and opportunity to participate in the company’s bonus program. Comprehensive medical, dental, vision and life insurance. Flexible paid leave and vacation policy. 401(k) plan with matching contributions. About Monogram HealthMonogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram seeks to fill systemic gaps and transform the way nephrology, primary care and chronic condition treatment are delivered. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease.
At Monogram Health we believe in fostering an inclusive environment in which employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams, and welcome those from all backgrounds and varying experiences.
Read LessThe Bilingual Engagement Specialist I is the first Monogram Health voice the patient meets. The Engagement Specialist is responsible for reaching out to patients over the phone to begin the process of educating them about existing benefits of their healthcare plan and encouraging and facilitating their enrollment into our program. The Patient Care Center is open and staffed seven (7) days per week between the core business hours of 8:00am to 7:00pm (CST) Monday through Friday, and 8:00 am – 5:00 pm (CST) Saturday and Sunday. The selected individual will be required to work on-site and may be required to work weekends and holidays. All Patient Care Center staff are expected to demonstrate adaptability, empowerment, collaboration, ownership, compassion, and integrity.
Roles and ResponsibilitiesConducts a high volume of outbound calls, hot or cold leads, to prospective patients and receives inbound calls from patients and providers.Effectively communicates and sells the value of Monogram Health based on the needs of our patients to increase enrollment.Conducts outreach to existing patients to schedule annual exams or re-engage as necessary based on missed or needed visits; can reinforce the value of our services and overcome objectionsAdheres to procedures, workflows, and scripts to ensure confirmation of HIPPA and Health Plan eligibility and accurate and applicable communications and information about Monogram Health services.Protects the health care privacy of patients by strictly following HIPAA regulations.Notates and enters data as needed into Salesforce, as required to support all activities of the call.Fields call with a positive attitude, building rapport and trust with patients.Supports Monogram Health as necessary with any tasks required to deliver excellent personalized care and performs all other job-related duties as assigned.Proficiency in using various software, electronic health record platform(s), and multiple screens.Essential Job Functions:Visual acuity – 100% to read scripts, company literature such as workflow guides and resources, electronic files, patient demographics.Hearing – 100%– ability to hear and respond to phone calls, converse with patients, colleagues, and others.Manual dexterity for repetitive motion 100% - essential for keyboarding, data entry, patient call documentation and dispositioning, and as necessary computer dialing.Sitting - 100%Standing – 5%Walking – 2%On-site position – 100%Position RequirementsHigh School Diploma or GED required.Must be 18 years of age or older.English language proficiency required; bilingual (Spanish/English) preferred.Proven ability to learn and retain information in an exceptionally fast-paced environment.Proven ability to balance multiple competing priorities while meeting or exceeding deadlines.Must possess an innate ability to overcome objections.Must be dependable, with a strong dedicated work ethic, attention to detail and accuracy.Thrive in a very fast paced start up environment while embracing change with a "can do" attitude.Demonstrated verbal, listening, and written communication skills are required.Demonstrated experience in sales, telemarketing, in the health care industry and heavy outbound appointment setting is a significant and strongly preferred. Knowledge of medical terminologyPrevious home health and care management experience preferred.BenefitsOpportunity to work in a dynamic, fast-paced, and innovative value-based provider organization that is transforming the delivery of kidney care.Comprehensive medical, dental, vision and life insuranceFlexible paid leave and vacation policy401(k) plan with matching contributionsAbout Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
Read LessWe are looking for a detail-oriented and compassionate Client Grievance Specialist to join our team. The ideal candidate will be responsible for managing, investigating, and resolving patient complaints and grievances in compliance with CMS standards and health plan contractual obligations. This role is essential in ensuring patient satisfaction, compliance, and continuous quality improvement.
Roles and ResponsibilitiesAcknowledge, examine, and investigate patient complaints by reviewing call logs/recordings while leveraging internal systems for researchMaintain accurate records and documentation within internal systemsUse critical thinking to independently manage complex or escalated cases with minimal supervisionCollaborate with internal teams to collect all necessary informationPrepare and submit summary reports and findings regarding grievances to the relevant department managersReport to Health Plan Partners as per contractual obligationsIdentify trends or recurring issues and escalate them to leadership for quality improvement initiativesManage grievances in accordance with Centers for Medicare and Medicaid (CMS) standards, ensuring timely resolution and responses that comply with applicable regulations and internal guidelines.Position RequirementsAssociate or bachelor’s degree in healthcare administration or a related field (or equivalent experience).Strong analytical, problem-solving, and written/verbal communication skillsProficiency with Microsoft Office SuiteSalesforce and Athena are experience a plusBenefitsOpportunity to work in a dynamic, fast-paced and innovative value-based provider organization that is transforming the delivery of kidney careCompetitive salaryComprehensive medical, dental, vision and life insuranceFlexible paid leave and vacation policy401(k) plan with matching contributionsAbout Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. .
Read LessAt Monogram Health, we are transforming care for high-risk patients with multiple chronic conditions, and as a Field Sales Representative, you are at the heart of that mission. In this role, you will engage face-to-face with Monogram-eligible patients who could benefit from our services but are not currently enrolled in our program. By educating patients on Monogram, answering their questions, and building their trust, you’ll help connect them to life-changing care. Your outreach has the power to dramatically improve someone’s health, well-being, and quality of life, making every visit an opportunity to make a meaningful difference.
About the Role
We’re seeking a highly motivated and energetic Field Sales Representative to join our growing sales outreach team. This role is ideal for someone who thrives in face-to-face environments, enjoys being on the move, and is passionate about creating lasting customer relationships. You’ll be the face of our brand, actively engaging with potential members in their homes on a daily basis.
What You’ll Do
Conduct daily in-person outreach to high-risk, hard-to-reach patients by visiting their homes unannounced and educating them in-person about the Monogram Health programProactively schedules and completes at least 10 home visits dailyDrive a designated territory daily to engage new and existing membersMeet or exceed sales targets and KPIsFacilitate a high completion rate of scheduled visitsCollaborate with internal sales and marketing teams to optimize outreach strategiesMaintain accurate records in CRM systemsWhat We’re Looking For
Previous experience as a Field Sales Rep, SDR, BDR, Account Executive, or similar is helpful but not requiredComfortable with outdoor, door-to-door, or on-location outreachMust have a valid driver’s license and reliable vehicle for travel and willingness to travel heavily dailyStrong interpersonal and communication skillsHigh level of self-motivation and independenceResults-driven, with a hunter mentalityAbility to adapt to different customer types and field scenariosTech-savvy enough to manage CRM updates, email follow-ups, and basic reportingWhy Join Us?
Competitive compensation with performance bonusesMileage reimbursementComprehensive training and sales supportChance to make a visible impact in the community and with customersReady to hit the ground running and make sales happen face-to-face? Apply today!
About Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
Read LessAt Monogram Health, we are transforming care for high-risk patients with multiple chronic conditions, and as a Field Sales Representative, you are at the heart of that mission. In this role, you will engage face-to-face with Monogram-eligible patients who could benefit from our services but are not currently enrolled in our program. By educating patients on Monogram, answering their questions, and building their trust, you’ll help connect them to life-changing care. Your outreach has the power to dramatically improve someone’s health, well-being, and quality of life, making every visit an opportunity to make a meaningful difference.
About the Role
We’re seeking a highly motivated and energetic Field Sales Representative to join our growing sales outreach team. This role is ideal for someone who thrives in face-to-face environments, enjoys being on the move, and is passionate about creating lasting customer relationships. You’ll be the face of our brand, actively engaging with potential members in their homes on a daily basis.
What You’ll Do
Conduct daily in-person outreach to high-risk, hard-to-reach patients by visiting their homes unannounced and educating them in-person about the Monogram Health programProactively schedules and completes at least 10 home visits dailyDrive a designated territory daily to engage new and existing membersMeet or exceed sales targets and KPIsFacilitate a high completion rate of scheduled visitsCollaborate with internal sales and marketing teams to optimize outreach strategiesMaintain accurate records in CRM systemsWhat We’re Looking For
Previous experience as a Field Sales Rep, SDR, BDR, Account Executive, or similar is helpful but not requiredComfortable with outdoor, door-to-door, or on-location outreachMust have a valid driver’s license and reliable vehicle for travel and willingness to travel heavily dailyStrong interpersonal and communication skillsHigh level of self-motivation and independenceResults-driven, with a hunter mentalityAbility to adapt to different customer types and field scenariosTech-savvy enough to manage CRM updates, email follow-ups, and basic reportingWhy Join Us?
Competitive compensation with performance bonusesMileage reimbursementComprehensive training and sales supportChance to make a visible impact in the community and with customersReady to hit the ground running and make sales happen face-to-face? Apply today!
About Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. Monogram Health is based in Nashville, Tennessee, operates throughout 37 states, and is privately held by Frist Cressey Ventures, Norwest Venture Partners, TPG Capital, as well as other leading strategic and financial investors. To learn more about Monogram Health, ranked by Inc. Magazine as 2024’s No. 3 fastest growing private company in the United States, please visit here.
Read LessMonogram Health is looking for skilled Registered Nurse eager for the opportunity to make a difference in patients' lives. The Care Manager RN is a key member of an integrated Care Team which includes an Advanced Practice Provider and a Social Worker. The patients we serve often struggle with multiple serious diseases. Registered Nurses help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes.
Your Impact:As a Registered Nurse, you are an integral part of building trusting relationships with patients, so that they can experience a high quality of life at home. Work with a small panel of patients where you can directly experience the impact of your care. In healthcare systems, the patient has too often become secondary due to processes and incentives that don’t positively impact the patient for the long term. Here at Monogram, we strive to change that narrative by putting our patients and their quality of life at the forefront of what we do.
Highlights & Benefits Flexible scheduling with a hybrid and in-home modelCompetitive compensation and a performance-based bonus programFull benefits package including medical, dental, vision, life insurance, 401(k) plan with matching contributions, paid vacation and holiday timeRoles and ResponsibilitiesWork closely with patients’ medical providers to develop and continually adapt care planPerform in-home care management visits to execute care management planMonitor biometric data and follow approved protocols for any necessary interventionsInventory and reconcile medications and coordinate with pharmacists and prescribersPerform patient health assessments and surveys as requiredDeliver individual and group education on CKD, ESRD, dialysis and associated comorbiditiesEncourage medication and treatment adherence through frequent contact with patientsEngage family and social support groups in the education and care of patientsServe as the primary point of contact and be the first call when patients have questions (business hours)Provide education and coaching around medications, medical conditions, diet, exercise, and lifestyle choicesEducate patients and facilitate conversations around proactive care decisions, especially relating to Advance Care Plans and ESRD treatment modalitiesObtain vital signs when visiting patient and escalate any concerns to the providerInitiate patient relationships through enrolment and onboarding processesPerform post-op and hospital discharge visits to help patients through vulnerable transitionsReview and document patient updates and progress in care management platformCoordinate with dialysis providers to ensure transitions of care are seamlessPosition RequirementsFrequent local travel to perform in-home visitsBasic Life Support (BLS) certification is required in this role. The company will support your certification completion through onboardingInfrequent domestic travel may be required, primarily to Brentwood, TN for trainingSelf-starter with the ability to work independently with minimal supervisionAbility to show empathy and quickly build relationships with patients and physiciansGraduate of an accredited School of NursingCurrently licensed as a Registered Nurse in the State of the posted location2+ years previous experience working in care management and/or with CKD/ESRD patientsAbility to take call remotely on some nights and weekendsExcellent verbal communication skills both in person and on the phoneFamiliarity with Microsoft Office and mobile phone and web-based applicationsAbout Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
Read LessMonogram Health is looking for skilled Registered Nurse eager for the opportunity to make a difference in patients' lives. The Care Manager RN is a key member of an integrated Care Team which includes an Advanced Practice Provider and a Social Worker. The patients we serve often struggle with multiple serious diseases. Registered Nurses help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes.
Your Impact:As a Registered Nurse, you are an integral part of building trusting relationships with patients, so that they can experience a high quality of life at home. Work with a small panel of patients where you can directly experience the impact of your care. In healthcare systems, the patient has too often become secondary due to processes and incentives that don’t positively impact the patient for the long term. Here at Monogram, we strive to change that narrative by putting our patients and their quality of life at the forefront of what we do.
Highlights & Benefits Flexible scheduling with a hybrid and in-home modelCompetitive compensation and a performance-based bonus programFull benefits package including medical, dental, vision, life insurance, 401(k) plan with matching contributions, paid vacation and holiday timeRoles and ResponsibilitiesWork closely with patients’ medical providers to develop and continually adapt care planPerform in-home care management visits to execute care management planMonitor biometric data and follow approved protocols for any necessary interventionsInventory and reconcile medications and coordinate with pharmacists and prescribersPerform patient health assessments and surveys as requiredDeliver individual and group education on CKD, ESRD, dialysis and associated comorbiditiesEncourage medication and treatment adherence through frequent contact with patientsEngage family and social support groups in the education and care of patientsServe as the primary point of contact and be the first call when patients have questions (business hours)Provide education and coaching around medications, medical conditions, diet, exercise, and lifestyle choicesEducate patients and facilitate conversations around proactive care decisions, especially relating to Advance Care Plans and ESRD treatment modalitiesObtain vital signs when visiting patient and escalate any concerns to the providerInitiate patient relationships through enrolment and onboarding processesPerform post-op and hospital discharge visits to help patients through vulnerable transitionsReview and document patient updates and progress in care management platformCoordinate with dialysis providers to ensure transitions of care are seamlessPosition RequirementsFrequent local travel to perform in-home visitsBasic Life Support (BLS) certification is required in this role. The company will support your certification completion through onboardingInfrequent domestic travel may be required, primarily to Brentwood, TN for trainingSelf-starter with the ability to work independently with minimal supervisionAbility to show empathy and quickly build relationships with patients and physiciansGraduate of an accredited School of NursingCurrently licensed as a Registered Nurse in the State of the posted location2+ years previous experience working in care management and/or with CKD/ESRD patientsAbility to take call remotely on some nights and weekendsExcellent verbal communication skills both in person and on the phoneFamiliarity with Microsoft Office and mobile phone and web-based applicationsAbout Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
Read LessMonogram Health is looking for skilled Registered Nurse eager for the opportunity to make a difference in patients' lives. The Care Manager RN is a key member of an integrated Care Team which includes an Advanced Practice Provider and a Social Worker. The patients we serve often struggle with multiple serious diseases. Registered Nurses help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes.
Your Impact:As a Registered Nurse, you are an integral part of building trusting relationships with patients, so that they can experience a high quality of life at home. Work with a small panel of patients where you can directly experience the impact of your care. In healthcare systems, the patient has too often become secondary due to processes and incentives that don’t positively impact the patient for the long term. Here at Monogram, we strive to change that narrative by putting our patients and their quality of life at the forefront of what we do.
Highlights & Benefits Flexible scheduling with a hybrid and in-home modelCompetitive compensation and a performance-based bonus programFull benefits package including medical, dental, vision, life insurance, 401(k) plan with matching contributions, paid vacation and holiday timeRoles and ResponsibilitiesWork closely with patients’ medical providers to develop and continually adapt care planPerform in-home care management visits to execute care management planMonitor biometric data and follow approved protocols for any necessary interventionsInventory and reconcile medications and coordinate with pharmacists and prescribersPerform patient health assessments and surveys as requiredDeliver individual and group education on CKD, ESRD, dialysis and associated comorbiditiesEncourage medication and treatment adherence through frequent contact with patientsEngage family and social support groups in the education and care of patientsServe as the primary point of contact and be the first call when patients have questions (business hours)Provide education and coaching around medications, medical conditions, diet, exercise, and lifestyle choicesEducate patients and facilitate conversations around proactive care decisions, especially relating to Advance Care Plans and ESRD treatment modalitiesObtain vital signs when visiting patient and escalate any concerns to the providerInitiate patient relationships through enrolment and onboarding processesPerform post-op and hospital discharge visits to help patients through vulnerable transitionsReview and document patient updates and progress in care management platformCoordinate with dialysis providers to ensure transitions of care are seamlessPosition RequirementsFrequent local travel to perform in-home visitsBasic Life Support (BLS) certification is required in this role. The company will support your certification completion through onboardingInfrequent domestic travel may be required, primarily to Brentwood, TN for trainingSelf-starter with the ability to work independently with minimal supervisionAbility to show empathy and quickly build relationships with patients and physiciansGraduate of an accredited School of NursingCurrently licensed as a Registered Nurse in the State of the posted location2+ years previous experience working in care management and/or with CKD/ESRD patientsAbility to take call remotely on some nights and weekendsExcellent verbal communication skills both in person and on the phoneFamiliarity with Microsoft Office and mobile phone and web-based applicationsAbout Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
Read Less