Care Manager II
3 weeks ago
At Miami Beach Medical Group, we are seeking a highly skilled Care Manager II to join our team. As a Care Manager II, you will play a critical role in facilitating patient care by overseeing the coordination and integration of health and care management functions.
Key Responsibilities:- Conduct Comprehensive Assessments: Conduct thorough assessments to identify individual patient needs and develop a specific care management plan to address objectives and goals.
- Evaluate Patient Risk: Evaluate patient risk factors, including fall risk, PHQ-9, health literacy, and risk of unplanned admission.
- Coordinate Care: Coordinate pre-admission, discharge, and admission processes to ensure seamless patient care.
- Identify High-Risk Populations: Identify high-risk populations, including high utilizers, multiple co-morbidities, polypharmacy, non-compliance, and risk for readmission.
- Monitor Homebound Patients: Monitor homebound patients and assist with home lab and home visit coordination.
- Assist with Medical Urgencies: Assist with medical urgencies, including IVs, wound care, medication administration, and other critical care needs.
- Participate in Interdisciplinary Care Team Meetings: Participate in Interdisciplinary Care Team meetings with patient providers, health plan care managers, and pharmacy team members to discuss patient progress and complex issues.
- Educate Patients: Educate patients about health plan benefits, CCMC services, and community resources.
- Assess Patient Needs: Assess patient needs for physical functional limitations, poor social support systems, and behavioral health needs.
- Problem-Solve with Providers: Assist in problem-solving with providers, utilization or service issues, prior authorization requests, and long-term care applications.
- Implement Cost-Saving Strategies: Implement activities to promote cost savings, including potentially preventing admissions, reducing readmissions, and improving generic dispensing rates.
- Assist with HEDIS/Preventive Health Screenings: Assist patients with coordinating care pertaining to HEDIS/Preventive health screenings.
- Education: Associate degree in nursing required, bachelor's degree preferred.
- License: Active Registered Nurse license in Florida.
- Experience: Three years of acute clinical experience required, three years of care or case management experience in a hospital, health plan, or clinic setting required.
- Skills: Proficient computer skills, including experience with Microsoft Excel, Word, and Outlook. Strong written and verbal communication skills, excellent clinical assessment and analytical skills.
Miami Beach Medical Group is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to providing an inclusive workplace where employees excel based on personal merit, qualifications, experience, ability, and job performance.
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