Family Physicians Group

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Complex Case Manager

at Family Physicians Group

Posted: 9/12/2019
Job Status: Full Time
Job Reference #: 4be54403-2839-452d-844f-1b840f816ff8
Keywords: health, patient

Job Description

The Complex Case Manager manages a cohort of Medicare Advantage patients to help ensure they receive the “right care at the right time in the right place” to improve clinical outcomes. Employing a variety of strategies and techniques the Complex Case Manager assists the patient in managing their health issues. Through use of assessment, data, conversations with member, and active care planning, the Complex Case Manager ensures the patient is continually progressing towards the desired outcome.

Requirements

  • Knowledge of Medicare Parts A, B, and D.

  • Medicare Advantage experience a plus

  • Case Management experience.

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

  • Detail oriented and comfortable working with tight deadlines in a fast-paced environment

  • Strong verbal and written communication skills

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:

  • Promote timely access to appropriate care.

  • Increase utilization of preventative care.

  • Increase comprehension through culturally and linguistically appropriate education.

  • Create and 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 and increasing patient satisfaction.

  • 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 to clients and other employees of the organization.

    Bi-lingual in English and Spanish a plus

Education and Experience

  • Current State of Florida Registered Nurse.

  • Case Management experience preferred

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. 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

Non- Exempt

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.