Patient Care Manager Position Available In Pasco, Florida

Patient Care Manager

VERIMED IPA LLC – 3.0

Wesley Chapel, FL Job Details Full-time $55,000 – $65,000 a year 20 hours ago Qualifications Microsoft Powerpoint Microsoft Word Microsoft Excel Microsoft Outlook Data mining Management RN License Mid-level 3 years LPN Acute care Certified Case Manager Associate’s degree Care plans Communication skills Nursing Full Job Description veri

MED IPA, LLC

is one of the leading Medicare Advantage Independent Practice Associations in the Greater Tampa Bay area. We currently provide services to approximately 100 affiliated providers throughout fourteen counties in Central Florida . We are looking for a licensed nurse to join our team as one of three Patient Care Managers (PCMs). This role is responsible for working with the Director of Patient Care and two other Patient Care Managers, working collaboratively to promote quality care and cost-effective outcomes that will enhance the physical, psycho-social, and vocational health of veriMED patient population. This position is a combination of remote work from home, working in the office, and regularly working in the field (visiting and supporting veriMed clinics and affiliate providers). The PCM will be required to work in the Wesley Chapel office at least once per week and must live in the South Hillsborough County or St. Pete area, since the individual in this role will often visit area clinics as well. If you meet the qualifications below, speak with you!

Responsibilities:

Identifies cases for individual management —from data mining, pre-certification process, plan referral or information collected from patients, providers, and caregivers. Conducts thorough assessment, develops, and implements a case management plan, including goals, as appropriate Implements the care plan and manages case to conclusion, while maintaining accurate records and adhering to patient privacies (HIPPA). Uses established evidenced based guidelines/criteria to evaluate treatment plans and goals based on information obtained from attending physician and/or other providers. Refers cases that do not meet evidenced based guidelines/criteria to appropriate clinical advisor (Primary Care Provider, Medical director, etc.) Refer patients to appropriate resources to allow for positive outcomes relating to their disease state Educate and assist patients in understanding their condition to improve self-management and maximize their health status potential Identifies potential cost savings within a health plan’s coverage. Acts upon cost savings in instances when services would not be sacrificed by doing so Obtains/maintains knowledge of Federal, State, and Local regulations , funding, and community resources available to patients and their families Performs all job duties and responsibilities within the scope of State & Federal laws , licensure/certification as well as within the ethics described in the CMSA’s Standards of Practice Maintains essential license and/or job‐related educational requirements Provider referral process oversight where necessary and indicated Frequent monitoring of members in inpatient settings through direct contact with attending providers, case managers, social workers and/or care coordinators. Other duties as assigned Minimum of three years nursing experienc e in an acute care or relevant setting. LPN or RN with active and unrestricted license to practice in the state Florida Certification in appropriate field of expertise (i.e.: Certified Case Manager, Chronic Care Professional), preferred Ability to attend to numerous details under the stress of maintaining courteous, professional, accurate and timely relations with a variety of individuals Ability to work independently, with minimal supervision Ability to comprehend the consequences of various problem situations and to refer such problems to the appropriate individual (or supervisor) for timely decision‐making Ability to research and address root causes of problems and to deal with conflict resolutions in a timely professional manner Proficient in Word, Excel, PowerPoint, eClinical Works , Outlook Excellent written and verbal communication skills Excellent interpersonal skills