Care Manager (RN, LPN, BSW, Psychology, Sociology) Region #11 Details

FLORIDA COMMUNITY CARE - Miami, FL

Employment Type : Full-Time

POSITION SUMMARY/ OBJECTIVE

The Care Manager is responsible for care management services of members enrolled in Florida
Community Care (FCC) to promote effective education, self-management support, and timely healthcare delivery to achieve optimal quality and positive outcomes. The Care Manager behaves in a professional manner, and consistently demonstrates and promotes the values of respect, honesty, care and dignity for the members as well as all other team members involved in the servicing of FCC clients. The Care Manager is involved in care management services for the diverse member population that FCC services. The Care
Manager will be responsible for the development and ongoing maintenance of individualized care plans using available data.

REQUIREMENTS FOR ALL POSITIONS

All employees shall meet specified training programs including Compliance/Privacy Regulations, and attend at a minimum one (1) hour of Compliance/Privacy educational training annually, as required by

Florida Community Care (FCC).

All employees shall meet Risk Management Regulations, and attend at the minimum one (1) hour of Risk

Management education and training within the first thirty (30) days of employment and as required by law or Florida Community Care; and, for that non-physician in clinical direct care delivery services, annually thereafter.

All employees if duly licensed in the State of employment, and said license is part of requirement of their position with Florida Community Care, shall maintain in good standing and current state licensure.

All employees are required to maintain confidentiality, protect privacy, comply with PHI regulations, and report violations.

POSITION RESPONSIBILITIES AND ACCOUNTABILITY

Core duties and responsibilities include the following. Other duties may be assigned.

1) Assessing clients’ needs in a comprehensive manner.
2) Coordinating services through community care planning system.
3) All Care Managers must be 701B certified.
4) All Care Managers must become certified in Person Centered Care Planning (PCCP)
5) All Care Managers must attend mandatory FCC trainings as needed.

Florida Community Care LLC4601 NW 77th Ave Doral, FL 33166
JOB DESCRIPTION 1

6) The care managers’ major duties are as follows:
1. Completes initial assessment and annual assessment using the Florida 701B. All 701B assessments will be done face-to-face. The assessment helps to identify the client’s conditions and resources
2. Completed supplemental assessments
3. Develops and reviews care plan in conjunction with client/client’s representative, d) Arranges appropriate services and coordinates service delivery with other professionals involved with service provision. e) Encourages and provides education and training to caregivers, family members or friends; f) Completes and maintains a client record with progress reports and forms related to service provision and ongoing documentation; g) Performs other duties as necessary; h) Interacts telephonically with member to maintain member’s individualized care plan using the available data; i) Maintains the following caseloads (as per state requirements): i. ratio of 1 care manager to sixty (60) members for enrollees residing in the community ii. ratio of 1 care manager to 100 members for enrollees age twenty-one (21) years or older that reside in a nursing facility iii. except a ratio of 1 care manager to forty (40) enrollees for enrollees under age twenty-one

(21) years receiving private duty nursing services in their family home or other community- based setting j) Evaluates the effectiveness of the care plan in meeting established care goals; revises components of the care plan as needed to reflect changing needs, problems, and goals; k) Identifies and effectively benefits and community resources to meet the needs of members and caregivers; l) Makes appropriate referrals to other programs/agencies to address the member’s needs; m) Promotes member self-management and empowers members/caregivers to achieve maximum levels of wellness and independence; n) Serves as a liaison to providers, members and caregivers for coordination of services; o) Provides member with education during care management activities; p) Maintains clear and concise documentation in the electronic care management system;

Documentation must be entered the electronic management within 48 hours of occurrence. q) Participates in orientation and supervision of new personnel; r) Participates in regular team meetings and departmental in-services; s) Works in conjunction with others on the team and promotes collaborative teamwork; t) Adheres to organizational policies and procedure; u) Maintains a working knowledge of, and adheres to applicable federal/state regulations including but not limited to, laws related to patient confidentiality, release of information, and HIPAA; v) Maintains appropriate professional boundaries; w) Uses safe work practices. Promptly reports workplace and patient safety issues to supervisor; x) Interacts in a manner, which is professional, respectful, positive, helpful, and promotes trust; y) Maintains professional growth and development; z) Ability to work remote and work out of FCC office as caseload allows.

POSITION QUALIFICATIONS

Florida Community Care LLC4601 NW 77th Ave Doral, FL 33166
JOB DESCRIPTION 2

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

The requirements listed below are representative of the knowledge, skill, and/or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Basic computer skills including data entry (database), MS Word.
  • Strong communication skills including verbal and writing skills
  • Valid Driver’s License; reliable car with current insurance
  • Ability to work independently, while collaborating with other team members.
  • All care managers are required to obtain a successful Level II criminal history and/or background investigation
  • All Care Managers shall have at least four (4) hours of in-service training in the identification of abuse, neglect and exploitation and shall complete this training requirement annually.

KNOWLEDGE, SKILLS AND ABILITIES

  • Knowledge of AHCA, Florida Medicaid, NCQA, and AAAHC policies and procedures
  • Knowledge of Managed care and healthcare industry and practices.
  • Proficiency in Windows and Microsoft Office applications.
  • Ability to manage multiple priorities.
  • Ability to read, analyze and interpret the most complex documents.
  • Ability to read, analyze, and interpret state and federal managed care guidelines.
  • Ability to respond to common inquiries or complaints from members, physicians, regulatory agencies, or members of the business community.
  • Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems.
  • Excellent oral and written communication skills, bilingual preferred.
  • Process-oriented with documentation and project management skills.
  • Individual must show initiative and motivation and must demonstrate successful interpersonal relationship skills.

EDUCATION AND EXPERIENCE

Care Managers shall meet one for the following qualifications:

1. Care managers with the following qualifications shall also have a minimum of two (2) years of relevant experience: i. Bachelor’s degree in social work, sociology, psychology, gerontology or a related social services field. ii. Registered nurse, licensed to practice in the state of Florida iii. Bachelor’s degree in a field other than social science;

OR

Florida Community Care LLC4601 NW 77th Ave Doral, FL 33166
JOB DESCRIPTION 3

2. Care managers with the following qualifications shall also have a minimum of four (4) years of relevant experience: i. Licensed Practical Nurse, licensed in the state of Florida

3. Care Managers with a Master’s degree in social work, sociology, psychology, gerontology, or a related social services field may substitute experience obtained through a practicum, internship, or clinical rotation on an equivalent basis for up to one (1) year of the experience requirements.

4. Care Managers without the aforementioned qualifications may substitute professional human service experience on a year-for-year basis for the educational requirement.

5. Care Managers without a bachelor’s degree shall have a minimum of six (6) years of relevant experience.

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 occasionally required to stand; walk; sit; use hands, reach with hands and arms; talk and hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Must be able to work in a stressful environment.

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.

The noise level in the work environment is usually moderate.

DRUG FREE WORKPLACE

In compliance with the Drug-Free Workplace Act of 1988, Florida Community Care has a longstanding commitment to provide a safe, quality-oriented and productive work environment. Alcohol and drug abuse poses a threat to the health and safety of FCC employees and members and to the security of the company's equipment and facilities. For these reasons, FCC is committed to the elimination of drug and alcohol use and abuse in the workplace.

TRAVEL

This position requires up to 100% travel; typically travel is local during the business day.

Florida Community Care LLC4601 NW 77th Ave Doral, FL 33166
JOB DESCRIPTION 4

EEO STATEMENT

Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Type: Full-time

Pay: $0.00 per hour

Benefits:

  • Health insurance

Schedule:

  • Monday to Friday

Employer type:

  • Home care

Work Remotely:

  • Yes

Posted on : 4 years ago