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PURPOSE AND SCOPE:

This position is responsible for the operational oversight of the development of the Chronic Kidney Disease non-dialysis (CKD-ND) curriculum employees will utilize in their roles supporting CKD-ND patients and programs. This role also develops/adapts a CKD patient facing education and reference materials to achieve the best outcomes possible for late stage CKD patients. This role may require expert review of existing platform education for the adaptation of CKD. The role will spend part of the time providing individual and group Medical counseling to CKD-ND patients using multiple platforms: telephonically, visual video platform or in person at selected clinic/program locations.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

+ Utilizes and develops CKD resources and CKD educational materials for patient and staff education.

+ Acts as a clinical resource to staff on matters related to patient care.

+ Maintains excellent rapport and effective working relationships with physicians, nurses, managers, and administration.

+ Builds rapport and maintains effective relationships with patients and families. This includes being non-judgmental and using interpersonal skills to connect with patients, providing them with care that is comprehensive, and evidence informed.

+ Interviews patients and families to assess and evaluate social, financial, environmental, and medical factors impacting status; review patient information obtained from medical records, and/or health care providers to determine patient needs.

+ Utilizes evidenced-based counseling and behavior change techniques.

+ Documents in record based on established standards of practice.

+ Collaborates with other members of the CKD care team regarding patient referrals; discharge and continuing care plans.

+ Interviews, assesses, and develops plan for the institutional needs of clinic patients, in collaboration with attending physicians.

+ As necessary, maintains effective written and verbal communications with physicians' offices.

+ Documents education and assessment of outpatients in the electronic medical record.

+ Develops and presents group education classes, in specialized areas to staff, professional organizations, the community at large, media and/or contract institutions.

+ Develops and expands professional proficiency in selected or assigned areas of specialty (example: CKD, diabetes, hypertension ,obesity, etc.).

+ Informs and educates staff of current developments in the CKD specialty area.

+ Performs other related duties as assigned.

+ Provides general direction, guidance and feedback based upon professional standards and FMCNA guidelines to support employees within the assigned area in achieving the desired outcomes in the following: quality, patient satisfaction, teamwork, unit culture, and employee satisfaction.

+ Provides communication and training required for employees to meet clinical competencies, policies and procedures individually and/or through regional/area meetings. Facilitates implementation of FMCNA continuing education training opportunities to enhance the practice of all employees.

+ Coordinates orientation and training of all new employees within the assigned region/area with the assistance of Education Coordinators, Clinical Managers, and other disciplines.

+ Attends and participates in regional and team meetings as appropriate which may include quality team building and staff development and other meetings as appropriate. Collaborates with appropriate regional management staff as needed to achieve effective inter-disciplinary and intra-disciplinary relationships.

Qualifications

PHYSICAL DEMANDS AND WORKING CONDITIONS:

+ The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

+ The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials.

+ This position requires approximately 5% to 15% travel.

SUPERVISION:

+ None

EDUCATION AND REQUIRED CREDENTIALS:

+ Registered Dietitian with the Commission on Dietetic Registration or Masters in Social Workrequired.

+ State License, if required in the state of practice

EXPERIENCE AND SKILLS:

+ 5 – 8 years’ related experience or an equivalent combination of education and experience

+ Minimum 5 years related work experience in the ESRD/CKD space. Experience counseling patients with late stage CKD is preferred, however not required if has other experience in counseling patients with renal disease.

+ Proficient with Microsoft applications which may include Outlook, Word, Excel, PowerPoint, TEAMS and other web-based applications.

+ Excellent written and verbal communication skills, excellent organization skills with ability to work independently while paying close attention to details. Ability to comprehend and communicate complex verbal information in English to colleagues, patients, families, and external customers.

+ Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance. Seeksassistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.

+ Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.

+ Ability to provide a high level of customer service to patients, visitors, staff, and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

• **Social Work Services**

• Regular communication to patient care staff about behavioral health problems which may affect a patient’s response to overall medical care and management, discussion with healthcare providers about research trends, etc.

• Counsels individuals and groups in specialty area with varied case management and/or behavioral health needs, taking into consideration diagnosis, socio-economic, and educational backgrounds.

• Develops care plans utilizing clinical, biochemical, socio-economic, and psychosocial factors. Documents and communicates care plans through written and verbal systems (medical records, discussion at rounds or patient conferences).

• Maintains clinic records on CKD patients and participates in care planning/QA activities as necessary

• Participates in patient satisfaction and problem solving with social work and customer service issues.

• Provides input into department protocols for social work.

• Collaborates with Corporate Social Worker, Social Work Services Advisory Board and Lead Social Workers to target projects, design interventions and develop standardized counseling tools and education materials.

• Collaborates in the staffing of social work services related to CKD-ND patients. Provides input for staff MSW’s formal performance evaluations and provides informal feedback to the social worker throughout the year.

• Acts as a Licensed Master Social Worker consultant to colleagues and peers to optimize patient care.

• Ability to demonstrate full working knowledge of standard concepts and practices.

• Possesses demonstrated experience in CKD counseling and a proven ability to manage both people and systems effectively.

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America** **maintains** **a drug-free workplace** **in accordance with** **applicable federal and state laws.

+ Fully remote position.

+ Manages Social Work schedules

+ Communicates regularly with FKC leadership, IWH leadership SW and RD team about operational updates.

+ Produces and analyzes utilization and metrics involving Social Work working hours and referral volume.

+ Trains and onboards new SW staff supporting the CKD program

+ Analyzes and leverage data to promote Social Work referral among KCEs, Payors and interdisciplinary team.

+ Collaborates with IWH SW leadership on any changes affecting the SW role.

+ Decision-maker for coverage plan, state assignments, sunsetting coverage of staff.

EOE, disability/veterans