Location : Tampa, Hillsborough, Highlands, Polk, Hardee, Manatee Counties in FL state
Shift: M-F 8-5
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Job Responsibilities:
- Candidate must reside in FL and area of coverage. Minimum 2 years of clinical experience. Bi-Lingual Spanish/ English required and willing and able to travel 75% of their time to meet members face to face and surrounding counties/areas
- Complete at least 10 NF member assessments weekly
- Support the Health Plan Rebalancing Initiative goal of successful transitions: Assess, identify, screen and transition NH members into the community
- Follow up on CM referrals and visit current NH members in-person at least twice a week to complete the rebalancing events and screening assessments.
- Complete telephone or in-person contact to assess the home prior to discharge and identify any environmental support needed to support transition (i.e. ramp, DME installation etc.).
- Conduct an in-person Significant Change Visit with members and Rep if applicable, within 5 days of transition. Coordinate provision of services as needed, establish Plan of Care, and document all actions taken.
- Contact facility’s Business Office once a week to follow-up on mbr’s census and will coordinate with Social Services and CM to facilitate discharge.
- Work collaboratively with case managers to identify high risk community members and implement appropriate interventions to prevent lapses or coordinate safe transition (Upon receiving referral)
- Drive enhanced value of health care to increase member satisfaction and retention and drive new membership growth.
- Be involved in at least two community relations events per year
- Engage in building strong relationships that contribute towards member satisfaction and retention
Skills:
- Preferred Skills: Managed Care experience, Discharge coordination experience, Transition of care experience, Home Health experience, Case Management experience
- Position requires proficiency with computer skills which includes navigating multiple systems and ability to work in a fast-paced environment
- Experience Level: Specify the level of experience required mid-level
Education/Experience:
- Active, unrestricted and good standing RN license in the state of Florida with Associate Degree Required and BSN preferred.
