What are the responsibilities and job description for the Disease Management Nurse position at Personify Health?
Overview
Who We Are
Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.
Responsibilities
Ready to Transform Member Health Through Strategic Care Coordination?
We're seeking a skilled RN who can telephonically coordinate wellness and disease management programs focused on chronic conditions such as diabetes, asthma, COPD, CAD, CHF, atrial fibrillation, hypertension, and hyperlipidemia. As our Disease Management Nurse, you'll use national care guidelines to develop individualized care plans while partnering with members to improve their health outcomes and overall wellbeing.
What Makes This Role Different
✓ Chronic disease focus: Specialize in coordinating care for members with multiple chronic conditions requiring expert clinical guidance
✓ Evidence-based approach: Use national care guidelines and claims data to compare patients' current care with industry standards
✓ Care plan ownership: Create individualized care plans for each patient while providing close follow-up with actively managed members
✓ Population health impact: Track high-risk member groups and interventions to demonstrate overall health improvement within organization
What You'll Actually Do
Coordinate member outreach: Contact targeted members for health promotion and restoration using national care guidelines to compare current care level with industry standards.
Develop clinical insights: Use claims processing tools to review and research paid claim data, developing comprehensive clinical picture of member's health status and needs.
Create individualized plans: Design and implement individual care plans for each patient while providing close follow-up with actively managed members to ensure progress.
Facilitate care access: Work with patients to ensure they have primary care provider, assist in referrals to specialists, help obtain durable medical equipment, and review pricing for high-cost drugs.
Make strategic referrals: Evaluate and refer members for case management, prenatal program, or pharmacology review as clinically indicated for optimal outcomes.
Maintain comprehensive documentation: Document interventions and patient contact while maintaining privacy of member records and assisting in quarterly client reporting.
Track population outcomes: Monitor groups of high-risk members and interventions to demonstrate overall health improvement within organization through data-driven insights.
Meet performance standards: Achieve productivity, quality, and turnaround time requirements on daily, weekly, and monthly basis while maintaining quality care coordination.
Qualifications
What You Bring to Our Mission
The Clinical Foundation
We believe in total rewards that actually matter—not just competitive packages, but benefits that support how you want to live and work.
Your Wellbeing Comes First
No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!
Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.
In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $31 to $38. Note that compensation may vary based on location, skills, and experience.
We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.
#WeAreHiring #PersonifyHealth #TPA #HPA #Selffunded
Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@ personifyhealth .com . All of our legitimate openings can be found on the Personify Health Career Site .
Application Deadline: Open until position is filled.
Who We Are
Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.
Responsibilities
Ready to Transform Member Health Through Strategic Care Coordination?
We're seeking a skilled RN who can telephonically coordinate wellness and disease management programs focused on chronic conditions such as diabetes, asthma, COPD, CAD, CHF, atrial fibrillation, hypertension, and hyperlipidemia. As our Disease Management Nurse, you'll use national care guidelines to develop individualized care plans while partnering with members to improve their health outcomes and overall wellbeing.
What Makes This Role Different
✓ Chronic disease focus: Specialize in coordinating care for members with multiple chronic conditions requiring expert clinical guidance
✓ Evidence-based approach: Use national care guidelines and claims data to compare patients' current care with industry standards
✓ Care plan ownership: Create individualized care plans for each patient while providing close follow-up with actively managed members
✓ Population health impact: Track high-risk member groups and interventions to demonstrate overall health improvement within organization
What You'll Actually Do
Coordinate member outreach: Contact targeted members for health promotion and restoration using national care guidelines to compare current care level with industry standards.
Develop clinical insights: Use claims processing tools to review and research paid claim data, developing comprehensive clinical picture of member's health status and needs.
Create individualized plans: Design and implement individual care plans for each patient while providing close follow-up with actively managed members to ensure progress.
Facilitate care access: Work with patients to ensure they have primary care provider, assist in referrals to specialists, help obtain durable medical equipment, and review pricing for high-cost drugs.
Make strategic referrals: Evaluate and refer members for case management, prenatal program, or pharmacology review as clinically indicated for optimal outcomes.
Maintain comprehensive documentation: Document interventions and patient contact while maintaining privacy of member records and assisting in quarterly client reporting.
Track population outcomes: Monitor groups of high-risk members and interventions to demonstrate overall health improvement within organization through data-driven insights.
Meet performance standards: Achieve productivity, quality, and turnaround time requirements on daily, weekly, and monthly basis while maintaining quality care coordination.
Qualifications
What You Bring to Our Mission
The Clinical Foundation
- Graduation from accredited RN program required
- Possession of current United States RN license (may require additional licensing as business needs change)
- Prior experience in case management, coordinating wellness programs, or equivalent combination of education and experience
- Proficiency in Microsoft Excel, Word, PowerPoint, and Outlook
- Ability to use claims processing tools to review and research paid claim data
- Understanding of national care guidelines and industry standards for chronic disease management
- Strong written and verbal communication skills for telephonic member interactions
- Demonstrate ability to work independently with excellent clinical judgment
- Excellent interpersonal and communication skills including ability to give presentations to groups and individuals
- Good time management skills with highly organized approach to managing caseloads
- Capability to develop rapport with members over the phone while providing empathetic, evidence-based guidance
- Commitment to member privacy and accurate documentation of all interventions and patient contacts
We believe in total rewards that actually matter—not just competitive packages, but benefits that support how you want to live and work.
Your Wellbeing Comes First
- Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!)
- Mental health support and wellness programs designed by experts who get it
- Flexible work arrangements that fit your life, not the other way around
- Retirement planning support to help you build real wealth for the future
- Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
- Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
- Professional development opportunities and clear career progression paths
- Mentorship from industry leaders who want to see you succeed
- Learning budget to invest in skills that matter to your future
- People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation
- One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
- We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
- Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable
- Competitive base salary that rewards your success
- PTO policy because rest and recharge time is non-negotiable
- Benefits effective day one—because you shouldn’t have to wait to be taken care of
No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!
Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.
In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $31 to $38. Note that compensation may vary based on location, skills, and experience.
We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.
#WeAreHiring #PersonifyHealth #TPA #HPA #Selffunded
Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@ personifyhealth .com . All of our legitimate openings can be found on the Personify Health Career Site .
Application Deadline: Open until position is filled.
Salary : $31 - $38