Care / Case Manager - LPN/RN

at JSA Healthcare

Orlando, FL

Posted on Feb. 3, 2017

Full Time

Health Insurance, Life Insurance, Dental Insurance, Vision Insurance, 401k / Retirement Plan

Care /Case Manager (LPN/RN)
Orlando • Saint Cloud • Kissimmee • Winter Garden

If you are searching for a dynamic, leading-edge company that is focused on providing quality care for our patients and growth opportunities for our employees, you've found the right place!

Our reach extends from the Tampa Bay to Orlando to South Florida, including primary care centers (JSA Medical Group and HealthCare Partners South Florida) and pharmacies (AmeriDrug).

We have won numerous workplace awards including one of Modern Healthcare Magazine's Top 100 Best Places in Work in Healthcare and Top Places to Work for numerous years.

Our employees work in a safe, caring, primary-care environment with the support of a strong corporate team.

We are currently seeking a Care /Case Manager (LPN/RN) to join our team.

The Care Manager reports to the Director of Regional Operations and is responsible for the oversight of pre-certification, patient care management, discharge planning, and health plan compliance within the center.

Essential Functions:
• Monitor inpatient, outpatient, and SNF patients and initiate patient care arrangements. Report findings to Medical Management, Medical Director and Center Administrator.
• Responsible for patient care management to assure appropriate care is provided; reinforce patient education regarding preventative care, dietary restrictions, medications and other therapeutic regimens; coordinate home health and DME requests and provide recommendations to the Center Medical Director.
• Provide oversight in patient care evaluation, coordinate the collaboration of the Primary Care Provider and Consultants, and make suggestions to improve plans to meet patient needs.
• Assist with the monitoring of utilization management and make recommendations regarding effectiveness of health care resources, trending and intervention.
• Assist in the assessment of clinic operations and make recommendations as necessary.
• Assure compliance with HCFA guidelines and covered service guidelines.
• Assist with the contestation of Part A and Part B /claims as needed.
• Consistently apply guidelines to the medical record review process.
• Evaluate and recommend health delivery network changes with the site Medical Director and Center Administrator.
• Participate in QI projects. Attend Care Management Meetings.
• Participate in patient satisfaction program as required and follow up on all inpatient/outpatient discharges.
• Assist the Center Medical Director with the management of high-risk patient populations and appropriate Care management plans.
• Other duties as assigned.

• Minimum: LPN license in the State of Florida
• Preferred: RN license in the State of Florida

• 3 to 5 years of recent clinical nursing experience.
• Preferred: Previous care management, utilization review or discharge planning experience.
• Preferred: Managed care experience.

Knowledge, Skills, and Abilities:
• Ability to perform Care management
• Ability to travel locally at times for coverage of Care Managers at Clinic locations
• Knowledge and skill in the applications of the techniques and practices of the nursing profession
• Ability to explain medical instructions to patients and their families
• Ability to learn and understand appropriate Federal, State, and local regulations
• Ability to interact and deal tactfully with the public
• Ability to read, write, speak and understand the English language fluently
• Ability to communicate effectively, establish and maintain an effective working relationship with patients and staff and deal effectively and professionally under pressure
• Ability to travel locally at times for coverage of Care Managers at Clinic locations
• Must have consistent, punctual and reliable attendance

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