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Care Manager

University of South Florida Health

Location: Tampa, Florida
Type: Non-Remote
Posted on: October 5, 2020
This job is no longer available from the source.
Care Manager
University of South Florida Health
113 reviews
-
Tampa, FL
University of South Florida Health
113 reviews
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Reporting to the Quality Manager/Patient Safety Nurse the Care Manager assists high-risk patients across the continuum of care; serves as a primary point of contact for these patients’ providers across care settings; aims to better manage high risk patients in the primary care ambulatory setting by reducing care gaps in preventive and chronic care and reduce acute care and ED use. This individual will work closely with USF Health’s primary care physician offices and the Practice Transformation Coordinator to optimize quality, risk adjustment and general population health management.
Position Requirements
Educational Requirements:
Bachelor’s degree in Nursing required. RN with a state license to practice required.
Experience Requirements:
• Must have five (5) years’ experience in a healthcare setting with experience in Chronic Care Management/Case Management desirable
• Case Management or related Certification desirable
• Experience in complex patient care planning preferred.
• Proficient in Microsoft Office products, EPM, and EHR software preferred.
• Ability to function autonomously while keeping team members and leaders informed.
Strong writing, interpersonal communications and organizational skills is required.
Experience with Epic, Cerner or other EHR software systems a plus.
The Care Manager is a problem-solver, has good communication skills, and works effectively with multiple customers including patients, members of the care team, and payers. Embraces the role of a variety of professional staff and their ability to contribute to improvement.
Knowledge/Business Skill Requirements:
Knowledge of statistical concepts. Knowledge of patient care process, PCMH, NCQA, MACRA.
Prior experience with computer software programs and data analytics required, such as: Microsoft Word, Microsoft Excel, Visio and other database programs
Preferred Attributes:
Customer Service Performance
CUSTOMER SERVICE PERFORMANCE EXPECTATIONS : Courteous and helpful behavior towards patients, physicians, coworkers and external customers; professional and efficient verbal and written communications; accomplishing tasks through teamwork and initiative; and ensuring a timely and thorough response to complaints and/or critiques, and anticipating the needs of all you come in contact with.
Physical Demands
Special Instructions to Applicants
Location
UPC BLDG - USF TAMPA
Department Name
UMSA Administration - Quality
Work Schedule Summary
Specific Duties and Responsibilities
Percentage
50
Duties
Manages day-to-day activities for early identification of gaps in patient preventative and/or chronic health care needs based upon health assessments or risk evaluation obtained through MDInsight or other population health data sources. Collaborates with primary care medical staff/nursing/medical assistants to identify high-risk patients, assess clinical and psychosocial needs, make referrals to ancillary providers (disease management, pharmacy, community organizations, non-clinical services), and develop population health evidence based care plans in coordination with PCP/care team and patients. Develop and implement individualized patient care plan (that is goal driven) with a focus on disease management and patient empowerment. Participate in the coordination and continuity of care during transitions in care settings (e.g. acute care, sub-acute care and home care settings) in order to optimize health care utilization and costs. Monitor care plans and patients’ progress to goal achievement; revise plan as necessary providing education and support as appropriate.
Percentage
10
Duties
Assist with prioritizing patient outreach needs, verify patient appointments and track visits to ensure completion of applicable risk adjustment, quality and other necessary items to be performed at the time of visit.
Percentage
15
Duties
Assist with mining of provider electronic medical records systems for chart preparation and capture of information and pre-visit planning. Coordinate and communicate with provider office personnel on daily basis to include updates and progress reporting as directed. Participate as needed in daily morning phone huddle with clinic lead discussing planned activities, barriers and any other applicable information.
Percentage
10
Duties
Uses valid methodology to demonstrate measureable outcomes, barriers, opportunities, etc..
Runs periodic reports from internal and external data sources to risk stratify member populations to ensure assignment of high risk members to the care manager and focuses on making member connections to other health care resources designed to avoid costly utilization. Monitors and evaluates data from multiple sources to inspire new or changes in practices or workflows to continually improve upon the health of the USF Health population.
Percentage
5
Duties
Collaborate with the Clinically Integrated Network and Managed Care staff to optimize
success under new payment and care models that seek payer partnerships and incentives that align with USF Health goals of improving the overall health of our patient population.
Percentage
10
Duties
Participate in cross functional meetings as assigned.