Care Coordinator (LPN/FMG)

Under the general supervision of the Director of Health Services, the position is responsible for collaborating with a plan Case Manager (RN) on the ongoing assessment, planning, and evaluation of members in the Care Management Program(s). The incumbent acts as a liaison between patient/family and healthcare personnel to ensure that the necessary care is provided promptly and effectively. The Case Coordinator will be accountable for understanding all aspects of the Leon Health’s Care Management Program.*ESSENTIAL DUTIES AND RESPONSIBILITIES*Oversee non-clinical and administrative staffResponsible for MOC activities, including processing of HRA’s, individualized care plan,interdisciplinary care team and care transitionsManage D-SNP members collaboratively with a plan Registered Nurse, in particular those belonging tothe most vulnerable populationIdentify needs and create a care plan, with the input of the member’s interdisciplinary care team, tohelp the member achieve their goalsSupport ongoing member engagementAddress the member’s individual needs, strengths, preferences, and goalsEducate members on their conditions and promote self-management skills including the understanding signs and symptoms that indicate a need to contact the PCP, and when it is appropriate to seek urgent or emergent careSupport medication adherenceEngage in member-centric discharge planningEnsure timely initiation of post-discharge services and careLink members to available community supportsCoordinate with case managers and providersCommunicate and coordinate with the member and their caregivers, practitioners, behavioral healthproviders, disease management staff, and other members of the ICT to ensure that the member’sneeds are addressed, and care transitions are communicatedReview and coordinate member cases with Medical Director(s)Supports standards that are consistent community and nationally recognized evidence-based practiceWorks collaboratively with Utilization Management staff to quickly and efficiently address any CareManagement or Utilization Management concerns or barriersIdentifies process improvement opportunities within Care ManagementWorks in partnership with plan compliance and clinical oversight to support Medicare and Medicaid (ifappropriate) grievance and appeals processes.Assists in peer training as needed.Participates in Quality Improvement and Risk Management activities as requested.Participates in training and in-service education as required.Complies with Leon Health’s policies and procedures and maintains confidentiality of patient’s medical records in accordance with state and federal laws.Maintains open channels of communication with other company departments.Answers all inquiries in a professional and courteous manner.Rotating on call-weekends.Participates in department, clinic and other meetings as requested.Complies with the organization's policies and procedures and maintains confidentiality in accordance with state and federal laws.Participates in special projects and performs other duties as assigned.QUALIFICATIONSMinimum of one (1) year of experience in Case ManagementProblem solving proficiency; the ability to systematically analyze problems, draw relevant conclusionsand devise appropriate courses of actionProcess/systems skills with the ability to work with data for data-driven decision making and processimprovementsMedicare and/or Medicaid managed care experienceKNOWLEDGE AND SKILLS REQUIRED:Knowledge of Dual Eligible Special Needs Plans, Centers for Medicare and Medicaid Services(CMS), and Florida MedicaidUnderstanding of Case Management best practicesStrong verbal and electronic communication skillsSupports positive employee relations and customer experienceUnderstanding of Microsoft Office Products and other appropriate software platformsAbility to work autonomously with self-directionEDUCATIONProof of completion of Licensed Practical Nurse (LPN) accredited program. Foreign Medical Graduate (FMG)LANGUAGE SKILLSBilingual English/Spanish fluency.CERTIFICATES, LICENSES, REGISTRATIONSLicensed Practical Nurse (LPN) accredited program, Foreign Medical Graduate (FMG)Schedule:8 hour shiftWork Location: In person #J-18808-Ljbffr Hunter Super Techs - TurnPoint