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LPN Case Manager
3 months ago
Do you want to make a difference in the community?
Are you looking to further your career in healthcare?
Do you want to be part of a growing organization?
Evara Health has been serving the community for 40 years. We are a not-for-profit health care organization with 14+ locations throughout Pinellas County, FL
General Description
Works under the direction of the Value Based Services Manager. Assist in the orientation, and training of other case managers, outreach workers and other care team members. Provide ongoing support and coordination/expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The overall goal of the position is to enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and management. Has accountability for the care coordination and planning of assigned Evara Health patients. Responsible for assisting in care team member ongoing readiness for accrediting agencies. Provides the medical care team with patient utilization information. Adheres to ethical and professional practices.
Essential Duties & Responsibilities
- Provides services that are consistent with the program methodology and in conformance with all program standards
- Assesses the level of need of individuals/families referred for case management services including those individuals with medically complex needs, chronic illnesses and intellectually challenged individuals and the elderly
- Meets with individuals and/or supportive family/responsible parties to assess and identify current needs/barriers and to establish patient directed/centered measurable goals
- Provides ongoing outreach and case management to a caseload of identified Evara Health patients (identified by medical providers and staff). Through record review and communication with patient, encourages patient compliance.
- Completes initial and ongoing documented telephonic contact with patients
- Builds and establishes trusting relationships with Evara Health patients through ongoing outreach and education thereby improving individuals’ physical and mental health (measured by a reduction of hospital ER visits and hospital admissions, satisfaction surveys, medical compliance). Advocates for individuals and their family members within the community, as needed
- Provides continuity of care as liaison to hospital discharge/case management staff and insurance representatives to assure follow up post emergency room visits/hospital admission discharge
- Links the individual/family with necessary resources to assist the family with needs and monitors the effectiveness of interventions being provided
- Provides case management services that are culturally competent, solution focused, strength based, recovery oriented, and co-occurring capable as they are needed by program families
- Completes all documentation within 24hrs as per agency standard including case records, and case notes, all pre-tests/ post-tests/ and outcome measures
- Uses appropriate crisis intervention skills, anticipates, and prevents crisis when possible
- Reports all risks to supervisor and ensures that risk notes and safety plans are completed as appropriate.
- Meets regularly with program manager to review cases and job performance; works closely with all care team members to assure consistency and cohesiveness; participates in daily huddles
- Keeps accurate records of caseloads and ensures that any required measures are completed and reported to data entry in a timely manner
- Performs accurate and comprehensive reviews of medical records
- Schedules and maintains appointments with providers and clinics to provide education related to reviews
- Provides education and training to physician groups/offices on correct coding initiatives
- Audits high volumes of medical records to ensure correct and appropriate code assignment; reports on findings resulting from chart audits
- Ensures policies and procedures are monitored and updated to include regulatory changes
- Knowledgeable of HEDIS and the use of HEDIS gap reports/Meaningful Use reports/data reports in relationship to clinical visits/billing and some coding knowledge
- Schedules and performs on-site medical records at center offices, viewed in compliance with HEDIS specifications
- 25-50% travel throughout Evara Health organization
- Strictly adheres to all Evara Health, HIPAA, HRSA, State, Federal and accreditation agency rules and regulations
Qualifications:
- Required: Graduate of an accredited LPN Program
- Required: Minimum two (2) years of experience as an LPN in a healthcare setting with some supervisory experience
Culture
Evara Health strives to not only be the healthcare provider of choice, but also the employer of choice, one that offers you the opportunity to excel in your career and be a difference maker in the lives of the patients we serve.
Benefits
- Up to 18 days of PTO in your first year
- 2 paid Mental Health Days
- Pre-Taxed flexible insurance package
- 403B with company contributions
- Tuition reimbursement
- Paid Training
