Group Home Medical Case Manager

Group Home Medical Case Manager

Quest, Inc. makes a difference in the lives of nearly 600 people each day. For over 60 years, Quest, Inc. has been committed to enriching the lives of individuals with disabilities by providing a path to independence, community inclusion, and empowerment. We are a trusted name in offering compassionate, quality support services, and we invite you to be a part of our team.

The Group Home Medical Case Manager is responsible for coordinating various aspects of patient care, from hospitalization and treatment plans to follow-up and outpatient services. Their work involves collaborating with healthcare professionals, insurance providers, and social services to create and implement comprehensive care plans tailored to each patient's unique needs.

The role will work Monday through Friday from 9:00 AM to 5:00 PM and on-call based on business need.

Responsibilities/You Will:

• Assessment of Patient/Doctor Relationships: Evaluate and assess patient/doctor relationships for our clients, ensuring effective communication and satisfaction with healthcare services.
• Medical Rounds Oversight: Oversee the medical rounds process, coordinating with healthcare providers to ensure timely and comprehensive medical care.
• Supervision of Medical Coordinators: Provide supervision and guidance to Medical Coordinators, ensuring their efficient and effective performance.
• Medical Information Transcription: Accurately transcribe medical information into the electronic health records system (EHR) or Avatar platform.
• Medicare and Insurance Application Oversight: Oversee the completion of client Medicare and insurance applications, addressing any related questions and concerns.
• Insurance and Prescription Management: Answer insurance-related inquiries, facilitate prescription payments, and schedule medical appointments as needed.
• Labs and MyChart Access: Obtain necessary logins for accessing medical labs and sharing information with authorized individuals. Ensure MyChart access information is readily available.
• Medication Administration: Oversee the administration of prescribed medications, monitor self-administration by clients, and adhere to protocols for medication disposal. Maintain medication inventory and liaise with pharmacies when necessary.
• Client Route and Staff Validation Tracking: Monitor client routes and validate staff credentials as required.
• Client-Specific Training Coordination: Collaborate with the Training department to coordinate client-specific training sessions, such as CPAP usage.
• Service Coordination: Facilitate coordination of physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) services for clients.
• Attendance at Routine Meetings: Attend scheduled routine meetings to provide updates and insights related to health services and client care.
• Stakeholder Communication: Maintain effective communication with various stakeholders involved in client care, ensuring all parties are well-informed.
• Custody Sheet Management: Ensure offsite custody sheets are completed and filed as necessary, adhering to relevant regulations.
• Incident Reporting: Collaborate with Directors to complete incident reports, such as those for Quest/APD incidents.
• Vital Sign Checks: Perform basic vital sign checks when required.
• Medical Appointment Scheduling: Oversee the scheduling of medical appointments for clients, ensuring timely access to healthcare services.
• Client Care Follow-Up: Monitor and ensure the continuity of client care from onset to resolution.
• Pharmacy and EHR Assessment: Collaborate with the VP of Residential to assess and recommend improvements for pharmacy services and the EHR system.
• Vaccine Clinic Management: Oversee and coordinate the setup of vaccine clinic, ensuring efficient and safe vaccination processes.
• Attend, participate and/or conduct all required training and monthly staff meetings.
• Follow all Quest policies and procedures.
• Employees are required to report serious issues to the employee hotline or to a Quest leader under the See Something Say Something policy.
• Management reserves the right to revise the job or to request that other or different tasks be performed as assigned.

Basic Qualifications/You Have:

• Associate's degree in medical assisting, nursing, or public health required.
• 1 year of verifiable experience as a Medical Assistant or similar role OR
• Active Registered Nurse (RN) license or Licensed Practical Nurse (LPN) in the state of Florida
• 2+ years of relevant experience in healthcare coordination, administration, or related roles.
• Proficiency in using electronic health records (EHR) and healthcare management software.
• Knowledge of medical terminology and basic medical procedures

Physical Demands:

• Sitting: Prolonged periods of sitting at a desk or computer while performing administrative tasks, such as transcribing medical information, overseeing applications, answering inquiries, and coordinating services.
• Walking: Occasional walking is required for activities such as attending meetings, conducting vital sign checks, monitoring client routes, and coordinating services on campus.
• Standing: While not a primary demand, standing may be necessary during meetings, clinic setups, or when supervising specific tasks.
• Lifting and Carrying: Occasional lifting or carrying of lightweight office supplies, paperwork, or medical records may be required.
• Fine Motor Skills: Precise keyboard and mouse usage is needed for accurate transcription of medical information and data entry into electronic health records.
• Communication: Effective verbal and written communication skills are essential for frequent interactions with clients, healthcare providers, and other stakeholders.
• Mental and Emotional Demands: Handling emotionally challenging situations and making critical decisions regarding healthcare coordination is part of the role.
• Time Management: Efficient time management is crucial for meeting deadlines, attending meetings, and ensuring the timely provision of healthcare services.

Required Skills/Abilities:

• Strong organizational and time management skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Proven problem-solving abilities
• Attention to detail and the ability to prioritize tasks effectively.

Quest, Inc. is a drug free workplace and an Equal Opportunity Employer. It is the policy of Quest to grant equal employment opportunities to all qualified persons without regard to race, color, sex, religion, age, national origin, disability, veteran's status, marital status, citizenship status, genetic information or any other category prohibited by local, state or federal statute.

Additional Benefits Information

• Stay healthy with enhanced coverage medical insurance includes an HRA, premium discounts, wellness credits, free virtual visits, free Minute Clinic visits, free imaging, and surgery
• Full smile & clear vision dental and vision plans to keep you covered head to toe
• Security for you and your family company-paid life and disability insurance coverage, plus long-term disability at no cost to you
• Short-term coverage when you need it short-term disability for life's unexpected moments
• Invest in your future 401(k) with a company match to grow your retirement savings
• Extra protection, your choice voluntary accident and hospitalization coverage available
• Save smarter flexible spending accounts (FSA) to help your dollars go further
• Support for life's challenges confidential Employee Assistance Program (EAP) to help you and yours
• Keep learning and growing- tuition assistance and tuition reimbursement to help you advance your education and career