Case Manager Inpatient and Outpatient setting (RN/LPN or Social Worker)
for section headings, - for lists,
for prose.
We should not repeat job title. No markdown.
We need to ensure we preserve all substantive info. Let's extract details precisely.
Let's list each piece:
From first paragraph:
- Ensuring continuity of care in both inpatient and outpatient setting.
- Utilizing appropriate resources within parameters of contracts and patients' health plan benefits.
- Facilitates continuum of patients' care utilizing nursing knowledge, experience and skills to ensure appropriate utilization of resources while ensuring high quality outcomes.
- Performs care management functions on-site or telephonically as the need arises.
- Reports findings to the Director of Care Management in a timely manner.
- Position can be fully remote/hybrid, but candidates must reside in the state of FL, GA, KY, NC, NV, PA, SC, TN, TX, VA, WI and PR.
- $500 Hiring bonus to be paid after 30 days of employment.
- Candidate must be able to visit the clinics as needed.
- Bilingual Is Preferred But Not Required.
- Compensation Based on Experience and Qualifications***.
- Typical work hours are Monday - Friday 8:00am to 5:00 pm with some flexibility.
Overall Job Purpose (run-on sentences but we can split):
- Implement processes for assigned panel of identified patients who would benefit from case and disease management.
- Assist patients to achieve highest level of wellness through timely and coordinated care management across the continuum of care.
- Comprehensively assess patients for gaps in care and collaborate with treating physicians to develop care plans that meet patient's (looks like missing word but we keep as is).
- Collaborate with primary care providers to develop action plans to reduce unplanned utilization of resources.
- Accountable to assure patients receive the right care, at the right level of care, and in the right setting, while working to reduce avoidable and unplanned utilization of resources.
- Provide patient coaching, anticipatory guidance, advocacy, and condition specific education.
- Communicate best practices to affiliated providers and their personnel to help facilitate effective clinical care and operational efficiency.
Objective:
- Enhance patient quality of care through reduction of avoidable admissions and emergency room utilization, and increase care to an optimal level with primary care providers and appropriate specialists.
Minimum Job Qualifications And Requirements:
- LPN or RN with current, unrestricted license in the state of Florida or Bachelors in Social Work.
- Experience: Three years in a professional setting such as hospital, clinic setting, or Managed Care Organization.
- Experience related to case management, utilization management, quality assurance, discharge planning or other cost management program preferred.
- Experience working with Medicare Advantage Population preferred.
- Social Worker, BSW Education (maybe redundant).
- Knowledge, Skills And Abilities:
- Excellent organizational, time management, and prioritization skills
- Critical thinking skills, excellent problem solving, and good decision making abilities
- Demonstrate a professional appearance and demeanor with patients, providers and coworkers.
- Proficiency with computers, experience in basic office programs and EMR or EHR systems.
About Maxhealth: description of company; we may include as "About the role" or maybe a separate "About Maxhealth" but not required headings. The instruction says use headings for sections like About the role, Responsibilities, etc. We can include About Maxhealth under "About the role" or maybe as a separate section "About the company". But only allowed headings are those listed; we could put company info under "About the role" as part of role description. However, the instruction: "Use
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It says e.g., meaning those are examples; we could also use other headings? Probably we should stick to those. The company description could go under "About the role" as part of role context. Or we could omit it if not required? The instruction: "Preserve ALL substantive information; do NOT invent or summarize away detail." So we need to keep the About Maxhealth paragraph. We can place it under a heading like "About Maxhealth" but that's not in the list. However, the instruction says "Use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." The "e.g." suggests those are examples, not an exhaustive list; we could use other headings if needed. But to be safe, we could incorporate the About Maxhealth paragraph into "About the role" section. That would preserve the info.
Thus sections:
- About the role: include overall job purpose, objective, and About Maxhealth description.
- Responsibilities: list of duties from first paragraph and overall purpose maybe overlapping; but we need to avoid duplication. We'll separate: Responsibilities: the specific duties (continuity of care, utilizing resources, facilitating continuum, performing care management functions, reporting findings, visiting clinics, etc.) plus maybe the processes implementation etc. But overall purpose also includes similar items. To avoid duplication, we could put overall purpose under About the role, and responsibilities under Responsibilities as the specific tasks. Let's decide.
About the role: overall job purpose and objective, plus About Maxhealth.
Responsibilities: the list of duties: ensuring continuity of care inpatient/outpatient, utilizing appropriate resources within contracts and health plan benefits, facilitating continuum of patients' care utilizing nursing knowledge/experience/skills, performing care management functions on-site or telephonically as needed, reporting findings to Director of Care Management timely, visiting clinics as needed, implementing processes for assigned panel, assisting patients achieve highest wellness, assessing gaps and collaborating with physicians to develop care plans, collaborating with PCPs to develop action plans to reduce unplanned utilization, assuring right care right level right setting while reducing avoidable/unplanned utilization, providing patient coaching, anticipatory guidance, advocacy, condition specific education, communicating best practices to affiliated providers and personnel.
Requirements: location (must reside in listed states), license (LPN/RN unrestricted in FL or BSW), ability to visit clinics as needed, bilingual preferred (but not required). Also maybe "Candidate must be able to visit
for prose. We should not repeat job title. No markdown. We need to ensure we preserve all substantive info. Let's extract details precisely. Let's list each piece: From first paragraph: - Ensuring continuity of care in both inpatient and outpatient setting. - Utilizing appropriate resources within parameters of contracts and patients' health plan benefits. - Facilitates continuum of patients' care utilizing nursing knowledge, experience and skills to ensure appropriate utilization of resources while ensuring high quality outcomes. - Performs care management functions on-site or telephonically as the need arises. - Reports findings to the Director of Care Management in a timely manner. - Position can be fully remote/hybrid, but candidates must reside in the state of FL, GA, KY, NC, NV, PA, SC, TN, TX, VA, WI and PR. - $500 Hiring bonus to be paid after 30 days of employment. - Candidate must be able to visit the clinics as needed. - Bilingual Is Preferred But Not Required. - Compensation Based on Experience and Qualifications***. - Typical work hours are Monday - Friday 8:00am to 5:00 pm with some flexibility. Overall Job Purpose (run-on sentences but we can split): - Implement processes for assigned panel of identified patients who would benefit from case and disease management. - Assist patients to achieve highest level of wellness through timely and coordinated care management across the continuum of care. - Comprehensively assess patients for gaps in care and collaborate with treating physicians to develop care plans that meet patient's (looks like missing word but we keep as is). - Collaborate with primary care providers to develop action plans to reduce unplanned utilization of resources. - Accountable to assure patients receive the right care, at the right level of care, and in the right setting, while working to reduce avoidable and unplanned utilization of resources. - Provide patient coaching, anticipatory guidance, advocacy, and condition specific education. - Communicate best practices to affiliated providers and their personnel to help facilitate effective clinical care and operational efficiency. Objective: - Enhance patient quality of care through reduction of avoidable admissions and emergency room utilization, and increase care to an optimal level with primary care providers and appropriate specialists. Minimum Job Qualifications And Requirements: - LPN or RN with current, unrestricted license in the state of Florida or Bachelors in Social Work. - Experience: Three years in a professional setting such as hospital, clinic setting, or Managed Care Organization. - Experience related to case management, utilization management, quality assurance, discharge planning or other cost management program preferred. - Experience working with Medicare Advantage Population preferred. - Social Worker, BSW Education (maybe redundant). - Knowledge, Skills And Abilities: - Excellent organizational, time management, and prioritization skills - Critical thinking skills, excellent problem solving, and good decision making abilities - Demonstrate a professional appearance and demeanor with patients, providers and coworkers. - Proficiency with computers, experience in basic office programs and EMR or EHR systems. About Maxhealth: description of company; we may include as "About the role" or maybe a separate "About Maxhealth" but not required headings. The instruction says use headings for sections like About the role, Responsibilities, etc. We can include About Maxhealth under "About the role" or maybe as a separate section "About the company". But only allowed headings are those listed; we could put company info under "About the role" as part of role description. However, the instruction: "Use