Care Manager

UniVida Medical Centers – Full Time – Miami, FL – Posted 4 years ago Care Manager: Description UniVida Medical Centers is seeking a Care Manager to perform care management for patients with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize patient health care across the care continuum. Supervisory Responsibilities No supervisory responsibilities Example of Duties Support and coordinate care with the patient’s primary care provider and other specialists as applicable Assist with identifying high risk population (i.e., high utilizers, multiple co‑morbidities, polypharmacy, non‑compliant, at risk for readmission, oxygen dependent, bed and wheelchair bound etc…) Conduct assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment(s) for patients enrolled in Care/Disease Management Provide patients with education on medical condition and co‑morbidities Ensures patient access to services appropriate to their health needs (i.e. community resources, social services, behavioral etc…) Implement care plans by facilitating patient needs as appropriate related to medical, psycho‑social, and psychiatric needs. Coordinate internal and external resources to meet patients’ needs Monitor and maintain inventory on urgency medications and supplies Assist and coordinate care regarding medical urgencies, not limited to assisting with IV’s, wound care, medication administration etc… Participate in Interdisciplinary Care Team (ICT) meetings with patient’s provider to communicate patients progress with his/her treatment plan, discuss complex issues or barriers to care Performs duties telephonically or on-site such as at hospitals for discharge planning Abide by Transition of Care (TOC) program description requirement Communicate and coordinate with hospital and health plans concurrent reviewer Complete Population Health Program activities and meet Key Performance Indicators as required in policies and procedures TOC High‑Risk Complex Disease Management (Diabetes, CHF, COPD) Telehealth Assist in problem solving with providers, utilization or service issues, prior authorization requests and long‑term care application Implement activities to promote cost savings such as: Potentially prevent admissions by coordinating outpatient care Reduce readmissions (Target 10%) Improve Generic Dispensing Rate Improve staff competence by providing educational resources; balancing work requirements with learning opportunities; evaluation the application of learning to changes in treatment results Assist patients with coordinating care pertaining to HEDIS/Preventive health screenings. (Target 5 Stars in all part C and Part D measures, 4 stars in Readmissions) Desirable Knowledge, Abilities And Skills Strong written and verbal communication skills Bi‑lingual preferred Time‑management and organizational skills Problem solving skills – Think critically and find potential solutions to problems Skills with Windows‑based operating systems and EHR Skills in operating phones, computers, software and other IT systems. Ability to communicate with employees, patients and other individuals in a professional and courteous manner. Ability to pay close attention to detail and to ensure accuracy of reports and data. Minimum Training And Experience High school education or higher At least two years of related work experience are preferred. Licenses and/or certifications: Medical Assistant, LPN, Registered Nurse, or Foreign Medical Practitioner or equivalent medical experience Physical demands This position works in one of our medical clinics. The employee is required interact with patients face to face and/or telephonically. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. #J-18808-Ljbffr