JobsEQ by Chmura Logo

Case Manager (Bilingual required)

Physician Partners

Location: Tampa, FL 33602
Type: Full-Time, Non-Remote
Posted on: April 18, 2021
This job is no longer available from the source.
5 STAR SERVICE
We want you on our team! Our team is responsible for ensuring the receipt of high quality, cost efficient medical outcomes for those patients identified as having the need for inpatient care and/or outpatient procedures.
THE OPPORTUNITY
We are currently searching for a competitive, self-motivated and enthusiastic team member to work within the Health Services team! As a part of this team you should have excellent organizational skills, an outgoing personality, and must be results-oriented, self-managed and motivated. The ability to work in a high-energy, fast-paced environment, along with strong attention to detail and relationship building skills are essential. Our team is responsible for building the relationships that allow us to continue shaping the future of healthcare!.
Essential Functions and Responsibilities:
Our ideal Team Member will promote the mission, vision, and values of the organization, identify quality of care issues and resolve them when possible. Identifying alternatives to care before admission and the ability to confirm care is medically necessary and rendered at the most appropriate level is crucial. Additionally, ensuring selection of the provider is appropriate and within the preferred network if possible. Our standards are high and they have set us apart from our competitors! Our GOAL is to review admitted members within 24-48 hours of admission and establish an appropriated discharge plan; identify patients with possible discharges to LTAC/IPR and communicate information to the CMO or Physician Consultant.
Other duties include and are not limited to:
• Promote the mission, vision, and values of the organization.
• Assess the physical, functional, social, psychological, environmental, learning and financial needs of patients.
• Identify problems, and create goals designed to meet patient’s needs, including prioritized goals that consider the patient/caregivers goals, preferences and desired levels of involvement in the case management plan
• Create a comprehensive care plan including objectives, goals and actions designed to meet patient’s needs
• Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and religious, developmental, health literacy, and educational backgrounds of the population served. Utilize interpreter services per policy.
• Assess the patient’s formal and informal support systems, including caregiver resources and involvement as well as available benefits and/or community resources
• Implement and monitor the care plan to ensure the effectiveness and appropriateness of services
• Evaluate patient’s progress toward goal achievement, including identification and evaluation of barriers to meeting or complying with case management plan of care, and systematically reassess for changes in goals and/or health status.
• Research alternative treatment options as well as select and locate appropriate providers which can include facilitation of referrals.
• Communicate with primary care physicians and Health Service’s team regarding patient status
• Utilize motivational interviewing skills to build patient engagement in case management plan of care
• Act as a patient advocate and assist with problem solving and addressing any barriers to care or compliance with care plans.
• Provide referrals to appropriate community resources and facilitate access and communication when multiple services are involved.
• Monitor activities to ensure that services are being delivered and meet the needs of the patient in addition to coordinating services to avoid duplication.
• Maintain accurate patient records and patient confidentiality.
• Measure outcomes and effectiveness of case management including clinical, financial, quality of life and patient/family satisfaction.
Qualifications & Licensure:
• Proof of successful completion of education requirements for a Nurse (RN or LPN) as defined by the state of Florida as well as proof of such licensure in good standing.
• CCM certification is a plus.
• Two years of prior experience with Utilization Management.
• Previous training and demonstrated competence in negotiations, Quality Assurance, and Case Management outcomes.
Skills, Abilities and Professional Competencies:
• Excellent relationship management skills.
• Demonstrated ability to problem solve complex, multifaceted, and emotionally charged situations.
• Ability to function with minimal supervision.
• Ability to successfully manage conflict, negotiating “win-win” solutions.
• Strong organizational, task prioritization skills.
• Computer literacy on G-Suite products and database programs.
• Patient advocacy focus.
• Empathy.
Working Conditions and Environmental/Physical Demands:
• Ability to use a computer keyboard and mouse 8 hours per day.
• Ability to dial, answer, and talk on the phone for 8 hours per day.
COMPENSATION & BENEFITS
• Base salary with bonus potential
• Medical, dental, vision, disability and life
• 401k, with employer match
• Paid time off
• Paid holidays
Experienced Employment Type: Full-Time