Family Physicians Group

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Complex Care Coordinator- LPN

at Family Physicians Group

Posted: 9/21/2019
Job Status: Full Time
Job Reference #: 6c06942e-b022-4b78-a2f2-95cd9004a124
Keywords: hospital, health, patient

Job Description

Under the direction of the Health Services Manager, the Complex Care Coordinator manages a cohort of Medicare Advantage patients to help ensure they receive the “right care at the right time” to improve clinical outcomes and lower costs. Utilizing an evidence-based approach the Case Manager will optimize care to determine what is medically necessary, while eliminating excessive treatment and expense.

Requirements:

  • Utilization knowledge on Part A, Part B and part D Medicare.

  • Medicare Advantage experience required

  • Knowledge of HEDIS

  • Case Management experience

  • Knowledge of the evidence based guidelines for the main chronic conditions-HTN, CAD, Heart Failure, Diabetes, CKD and COPD.

  • Ability to understand CMS guidelines.

  • Understanding of the basic principles for OSHA, CLIA, HIPAA and AHCA.

    Duties and responsibilities:

  • Works in collaboration and continuous partnership with chronically ill or “high-risk” patients and their family/caregiver(s) in a team approach to:

    · Reduce emergency room utilization and hospital readmissions

    · Promote timely access to appropriate care

    · Increase utilization of preventative care

    · Increase comprehension through culturally and linguistically appropriate education

    · Promote adherence to a care plan, developed in coordination with the patient, primary care provider, and family/caregiver(s)

    · Increase patients’ ability for self-management and shared decision-making

    · Connect patients to relevant community resources, with the goal of enhancing patient health and well-being, increasing patient satisfaction, and reducing health care costs

    Other Duties as assigned

Knowledge, Skills, and Abilities:

  • Knowledge of Electronic Medical Records.

  • Ability to be collaborative and effectively communicate with patient.

  • Ability to solve practical problems and deal with a variety of situations.

  • Ability to effectively present information in one-one and small group situations

  • Prefer bi-lingual in English and Spanish.

Education and Experience:

  • Current State of Florida Licensed Practical Nurse

  • Case Management experience required

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand and/or sit for extended period of time. The employee is occasionally required to sit. Specific vision abilities required by this job include close vision, color vision, and ability to adjust focus.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

FLSA Status:

This is an non-exempt position

Family Physicians Group is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.