Concurrent Review Specialist (RN)

Monogram 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.

The Concurrent Review Specialist (RN) is a key clinical role within the CRS Team following high risk readmissions and obtaining timely clinical updates to drive inpatient outcomes. The CRS is responsible for quick interventions to influence discharge planning and prevent readmissions. The CRS will serve as a liaison to the CRS Team for all readmission related topics. The CRS is responsible to work and collaborate with market Clinical Performance Managers, Medical Directors, and Care Managers to facilitate discharge plans. The CRS will take ownership of company-wide key performance indicators around hospital admission prevention and readmission reduction initiatives. This includes attending daily post hospital discharge visit meetings, tracking Monogram members at high-risk for readmission, and conducting telephonic outreach to facilities and members to complete targeted assessments aimed at reducing future hospitalization.

Initiate and actively participate in multidisciplinary discharge rounds as needed. Conduct telephonic outreach to high-risk members to complete post discharge assessments, targeted disease management assessments and periodic check-ins. Identify, track, and follow Monogram members at high-risk for hospital admission/readmission. Complete Peer 2 Peer request as need and ensure that all decisions and recommendations are executed. Develops and collaborates with market leaders and care managers on members post discharge care transition plan. Support Monogram Health as necessary with any tasks or projects required to deliver excellent personalized kidney care and perform all other duties as assigned.