Group Home Medical Case Manager

About the role

The Group Home Medical Case Manager is responsible for coordinating various aspects of patient care, from hospitalization and treatment plans to follow-up and outpatient services. Their work involves collaborating with healthcare professionals, insurance providers, and social services to create and implement comprehensive care plans tailored to each patient's unique needs. The role will work Monday through Friday from 9:00 AM to 5:00 PM and on-call based on business need.

Responsibilities

• Evaluation and assessment of patient/doctor relationships for our clients, ensuring effective communication and satisfaction with healthcare services.
• Overseeing the medical rounds process, coordinating with healthcare providers to ensure timely and comprehensive medical care.
• Providing supervision and guidance to Medical Coordinators, ensuring their efficient and effective performance.
• Accurately transcribing medical information into the electronic health records system (EHR) or Avatar platform.
• Oversight of the completion of client Medicare and insurance applications, addressing any related questions and concerns.
• Answering insurance-related inquiries, facilitating prescription payments, and scheduling medical appointments as needed.
• Obtaining necessary logins for accessing medical labs and sharing information with authorized individuals. Ensuring MyChart access information is readily available.
• Overseeing the administration of prescribed medications, monitoring self-administration by clients, and adhering to protocols for medication disposal.
• Maintaining medication inventory and liaising with pharmacies when necessary.
• Monitoring client routes and validating staff credentials as required.
• Collaborating with the Training department to coordinate client-specific training sessions, such as CPAP usage.
• Facilitating coordination of physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) services for clients.
• Attending scheduled routine meetings to provide updates and insights related to health services and client care.
• Maintaining effective communication with various stakeholders involved in client care, ensuring all parties are well-informed.
• Maintaining offsite custody sheets as necessary, adhering to relevant regulations.
• Collaborating with Directors to complete incident reports, such as those for Quest/APD incidents.
• Performing basic vital sign checks when required.
• Scheduling medical appointments for clients, ensuring timely access to healthcare services.
• Monitoring and ensuring the continuity of client care from onset to resolution.
• Collaborating with the VP of Residential to assess and recommend improvements for pharmacy services and the EHR system.
• Overseeing and coordinating the setup of vaccine clinics, ensuring efficient and safe vaccination processes.
• Attending, participating, and/or conducting all required training and monthly staff meetings.
• Following all Quest policies and procedures.

Qualifications

• Associate’s degree in medical assisting, nursing, or public health required.
• 1 year of verifiable experience as a Medical Assistant or similar role OR Active Registered Nurse (RN) license or Licensed Practical Nurse (LPN) in the state of Florida.
• 2+ years of relevant experience in healthcare coordination, administration, or related roles.
• Proficiency in using electronic health records (EHR) and healthcare management software.
• Knowledge of medical terminology and basic medical procedures.

Skills

• Strong organizational and time management skills.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proven problem-solving abilities.
• Attention to detail and the ability to prioritize tasks effectively.