Renal Clinical Case Manager

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🔥 0 minutes ago

🌵 Arizona, Idaho, +3 more states – Remote

🌵 Arizona – Remote 🥔 Idaho – Remote 🎰 Nevada – Remote 🌲 Oregon – Remote ☕ Washington – Remote

💵 $72k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

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Pentec Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1983

💼 Consulting

📦 Logistics

🏥 Healthcare

💰 $37M Private Equity Round - Pentec Health on 2012-06

Consulting • Logistics • Healthcare

Pentec Health is a national provider of clinical nutrition and specialty care that integrates specialty pharmacy and home-infusion services to support patients with complex medical conditions. They deliver personalized medical nutrition therapy (parenteral and enteral), metabolic medical foods, intrathecal and hepatic artery home infusion therapies, dialysis nutrition support, and specialty pharmacy management, along with clinician education, patient resources, and referral/portal tools. Pentec partners with clinicians and healthcare organizations to simplify complex care pathways and improve patient outcomes through accredited, community-based services.

📋 Description

• Provide clinical expertise in management of IDPN and IPN therapies • Manage internal aspects of therapy approval and authorization • Assist with clinical aspects needed for reimbursement within the Revenue Cycle Management team • Act as a clinical Subject Matter Resource for Renal Dietitians, Nurses, Nephrologists, Account Executives, field staff, and Revenue Cycle Management staff • Participate in Quality Management reviews of current and proposed processes and improvements • Assist in developing renal programs to increase the client base for IDPN/IPN and other Parenteral and Enteral Nutrition services • Provide clinical assistance for patients within the territory, including routine evaluation and monitoring of patients requiring IDPN and IPN nutritional therapies • Coordinate with CSR and AE staff to obtain monthly labs and payer-required documents for active patients • Assist Account Executives by reviewing the queue • Complete forms, documents, and letters/statements of medical necessity for renal centers, dialysis chains, or payors • Escalate insurance denials with Insurance Coordinators and/or Billers/Collectors through telephone consultations or written appeal letters • Organize or assist with CEU and Web-Ex CEU seminars • Conduct live displays and educational sessions regarding IDPN/IPN and other nutritional therapies • Perform other assigned duties and special projects

🎯 Requirements

• Must be located in the Pacific or Mountain Time Zone: Oregon, Washington State, Idaho, Nevada, or Arizona • BS degree in Nutrition or equivalent/related field • Must be a Registered Dietitian or Licensed Nutritionist as required by state, for at least two years • 1-2 years of practical experience in a full-service Dialysis facility • Experience in renal nutrition, especially in CKD 5 Dialysis • Experience in dialysis-related parenteral nutrition support therapies is required • IDPN experience required; IDPN/IPN preferred • Ability to work autonomously and make independent decisions within generally accepted medical practices, regulations, and guidelines • Intermediate computer skills with Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint

🏖️ Benefits

• Comprehensive compensation and full benefits package • Medical insurance • Dental insurance • Vision insurance • 401k match • PTO • Paid holidays • Disability insurance • Life insurance • Employee assistance • Flexible spending account or health savings account • Other additional voluntary benefits