Florida Medical Clinic Orlando Health
Florida Medical Clinic
Job Description
**REMOTE/HYBRID POSITION**
****8-12 weeks of training onsite at 17401 Commerce Park Blvd. Tampa, FL 33647******
DURING INITIAL TRAINING ROLE WILL BE HYBRID BUT WILL TRANSITION TO REMOTE, COMING TO THE OFFICE 1 DAY A WEEK (MUST BE IN THE IMMEDIATE TAMPA BAY REGION)
Title: LPN Care Manager Reports to: Manager/Care Team
As a Care Manager you will:
- Serve as the clinical bridge between the professional staff of the entire care continuum or in the community
- Serve as point of contact for members that have received ED, acute or post-acute services
- Collaborate with the care team to ensure appropriate and timely coordination of services
- Engage patient in various care delivery environments to ensure knowledge of program components, set expectations, eliminate barriers, and ensure compliance with program components
- Build and sustain strong relationships with client, members and providers
- Perform market research and surveillance to determine existing network and caregiver services
- Monitor and evaluate the effectiveness of the care management plan and modifies as necessary
- Identify gaps or barriers in treatment plans and provides appropriate education to fill in those gaps
- Make recommendations to the Interdisciplinary Care Team on continued patient needs from a utilization and care management perspective and effectively communicates and collaborates with the patient, family, physician(s), nursing, and other healthcare team members to coordinate care
- Conduct complete medication reviews and gathers information about medication
- Consult with medical providers regarding patient concerns and or actions that may impact compliance with care plans
A Day in the Life:
- Ensures successful delivery of all ordered post-acute/post-ED services closely collaborating with Post-Acute Network manager
- Engages post-acute institution based patients at the bedside to ensure compliance to next level of care plan and works with member/post-acute team to eliminate barriers to compliance
- Facilitates regular follow up with active members to ensure ongoing compliance with program components and eliminates barriers to compliance
- Ensures the approved in market processes utilized consistently with appropriate populations
- Promotes and supports the continuum of patient care including:
- Serves are “point of contact” for members, acute providers and client regarding care transitions and program components
- Responsible for performing care management within the scope of licensure for members with a variety of complex and/or chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during the assessment
- Communicate appropriate information to care providers in the continuum of care, monitors/reports utilization trends and intervenes as appropriate to ensure patients are connected with available resources
- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans
- Performs patient/family/caregiver education about treatment, self-management, and medications etc.
- Documents completed tasks and progress notes in care management system
What Success Looks Like in this Role:
- Coordinate with the patient/caregiver via phone, video or asynchronous messaging to ensure all physician appointments are made and kept, outpatient therapy is completed, lab/diagnostic testing, medication reconciliation is performed per the protocol and the patient’s physician
- Accountable for ensuring efficient and effective holistic approach for patients/families/caregivers across the care continuum
- Ability to maintain effective and professional relationships with patient and other members of the care team
- Ability to effectively engage patients in a therapeutic relationship
- A personal commitment to a person-centered approach, along with strong relationship-building, communication, and active listening skills required
- Maintains ongoing knowledge of Medicare guidelines, managed care, regulators changes at both the state and federal level, and other financial information
- Actively manages and engages full caseload
We are excited about you if you have these things:
- Current, unrestricted (Florida, RN) license (preferred) or LPN (minimum license level requirement)
- Bachelor’s degree in nursing or Associate Degree in Nursing with 3+ years in critical care, population management, or acute or chronic care experience
- Case Manager Certification (CCM) a plus
- Experience in either Utilization Management, Case Management, Disease Management or Discharge Planning preferred
- Prior telephonic care experience a plus
- Knowledge of population health a plus
- Beginner to intermediate experience working with reports/Excel
- Bilingual a plus
Additional Responsibilities:
- Maintains an organized and clean work area
- Participates in maintenance of clinical supplies
- Performs other incidental and related duties as required and assigned
We are an Equal Opportunity Employer and make employment decisions without regard to race, gender, disability or protected veteran status
Florida Medical Clinic Orlando Health is a drug-free workplace and maintains a policy in which new hires will be required to submit to pre-employment drug testing. This policy is intended to comply with applicable laws regarding drug testing and any privacy rights