DaVita LPN/RN Care Manager (West Colonial)Orlando, FL in ORLANDO, Florida

LPN/RN Care Manager (West Colonial)Orlando, FL

Description

HealthCare Partners, one of the country's largest operators of medical groups and physician networks, will continue to provide integrated care management as an operating division of DaVita HealthCare Partners, focusing on delivering outstanding healthcare across a broad range of services. HealthCare Partners works with its patients to help them live life to the fullest and strives to lead the transformation of the national healthcare delivery system to ensure quality, accessible and affordable care for all.

Since 1992, HealthCare Partners has been committed to developing innovative models of healthcare delivery that improve patients' quality of life while containing healthcare costs. HealthCare Partners manages and operates medical groups and affiliated physician networks in Arizona, California, Nevada, Florida, New Mexico, and Colorado. As of March 2015, HealthCare Partners had approximately 830,000 capitated under its care.

We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.

If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita HealthCare Partners may be the employer for you.

Overview:

The Care Manager reports to the Center Administrator 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.

Qualifications

Education:

  • Active nursing license in the State of Florida.

Experience:

  • 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

  • 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

  • Must have consistent, punctual and reliable attendance

Primary Location FL-ORLANDO - 32818

Req ID: 307528