KidneyTel's nurse care managers are the centerpiece of our disease management model. All nurse care managers complete a comprehensive training program and offer the following credentials:
• Care Management and or dialysis experience
• Licensed care managers in the state where they practice
• Experience in acute, peritoneal, hemodialysis and transplantation
• Trained renal nurse educators
The typical duties of our nurse care managers include the following.
• Review clinical information and conduct initial assessments for new referrals.
• Address the needs of high-risk patients. (For example, follow hospitalized patients, assist with discharge planning and conduct follow-up contacts post-discharge.)
• Assist new dialysis patients with any medical, educational or logistical needs. Review their medications, nutritional status and lab results.
• Assist existing patients with any clinical outliers, new or existing patient concerns, new or changed medications.
• Work with the patient‚’s health care team to facilitate continuity of care. It is our aim not to add a layer of bureaucracy, but to collaborate with and maximize the strengths of the existing system of care.
• Work with the patient’s health plan to establish authorizations for treatments, procedures, hospitalizations, DME and home health care. Review cases with health plan’s medical director as necessary.