DaVita Corporate Care Manager in ST. PETERSBURG, Florida
Corporate Care Manager
DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Nevada, New Mexico, Florida, Colorado and Washington in its pursuit to deliver excellent-quality health care in a dignified and compassionate manner. As of June 30, 2016 DaVita Medical Group (formerly HealthCare Partners) provided integrated care management for approximately 760,000 patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.
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 Medical Group may be the employer for you.
The Care Manager reports to the Manager of CareManagement and is responsible for the oversight of pre-certification, patientcare management, discharge planning, and health plan compliance within thecenter.
Monitor inpatient, outpatient, and SNF patients and initiatepatient care arrangements. Report findings to Medical Management,Medical Director and Center Administrator.
Responsible for patient care management to assureappropriate care is provided; reinforce patient education regardingpreventative care, dietary restrictions, medications and other therapeuticregimens; coordinate home health and DME requests and provide recommendationsto the Center Medical Director.
Provide oversight in patient care evaluation, coordinate thecollaboration of the Primary Care Provider and Consultants, and makesuggestions to improve plans to meet patient needs.
Assist with the monitoring of utilization management andmake recommendations regarding effectiveness of health care resources, trendingand intervention.
Assist in the assessment of clinic operations and makerecommendations as necessary.
Assure compliance with HCFA guidelines and covered serviceguidelines.
Assist with the contestation of Part A and Part B /claims asneeded.
Consistently apply guidelines to the medical record reviewprocess.
Evaluate and recommend health delivery network changes withthe site Medical Director and Center Administrator.
Participate in QI projects. Attend CareManagement Meetings.
Participate in patient satisfaction program as required andfollow up on all inpatient/outpatient discharges.
Assist the Center Medical Director with the management ofhigh-risk patient populations and appropriate Care managementplans.
Other duties as assigned.
* Education: *
Minimum: LPN licensein the State of Florida
Preferred :RNLicense in the State of Florida
* Experience: *
Minimum: Over 1 year andup to and including 3 years of clinical experience.
Minimum: At least 1 yearof recent clinical experience.
Preferred: 3 to 5 yearsof recent clinical nursing experience.
Preferred: Previous caremanagement, utilization review or discharge planning experience.
Preferred: Managed careexperience.
Knowledge, Skills, and Abilities:
Ability to perform Care management
Knowledge and skill in the applications of the techniquesand practices of the nursing profession
Ability to explain medical instructions to patients andtheir 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 Englishlanguage fluently
Ability to communicate effectively, establish and maintainan effective working relationship with patients and staff and deal effectivelyand professionally under pressure
Ability to travel locally
Must have consistent, punctual and reliable attendance
DaVita Medical Group is an equal opportunity/affirmative action employer. As such, DaVita Medical Group makes hiring decisions solely on the basis of qualifications and experience, and without regard to age, race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.
DaVita Medical Group will consider qualified applicants who have criminal histories in a manner consistent with the law.
Primary Location FL-ST. PETERSBURG - 33702
Req ID: 308747