Nurse Care Coordinator

Position Summary

Provide oversight to CPC staff and caregivers related to nursing and medical issues, as well as to serve as the single point of contact for physical health issues to Sunshine State, their contracted providers, and Children’s Medical Services (CMS), under the supervision of the Behavioral Health Supervisor.

Principal Duties and Responsibilities

• Ensure Child Welfare Specialty plan enrollment process is successful and covered enrollees and caregivers are engaged by providing ongoing program education in accordance with AHCA (Agency for Health Care Administration), Sunshine Health with contract requirements.
• Ensure required health information for covered enrollees is maintained as required with current PCP info, designated caregiver demographics, placement changes, etc.
• Upon enrollment in Sunshine Health, ensure that an initial Health Risk Assessment has been completed for all covered persons and submitted to Sunshine Health.
• Assist with ongoing management of healthcare needs by tracking additional assessment requests, reviewing individual health records, identifying service needs, maintaining periodic contact, and arranging for home visits as necessary.
• Participate in Sunshine Health discharge planning including monitoring the completion of post-discharge follow-up appointments, ordered services are scheduled and additional prescription medications are filled. Ensure Sunshine Health is notified when issues arise that may impact the status of the discharge.
• Monitor Children’s Medical Services (CMS) eligibility, completion of the application process for eligible participants, and transition to the CMS program. Coordinate with Sunshine Health to ensure required care plans are completed and caregiver participation in care plan meetings.
• Participate in the Children's Multidisciplinary Assessment Team (CMAT) staffings to ensure that appropriate services are being provided to children with complex medical needs through CMS. This includes initiating the CMAT referral process for all identified children who may be CMS Medical Foster Care candidates.
• Review the health and wellness reports from Sunshine Health for status of required healthcare visits/prescription refills and reach out to enrollees/caregivers as needed to ensure scheduling of needed appointments.
• Monitor medication/reconciliation activities to ensure all enrollees are in compliance with prescription orders, and report any identified issues to Sunshine Health.
• Review all Sunshine Health, FSFN and other data reports and coordinate with Health Services Coordinator and Case Management to assist in coordinating appropriate health care, including compliance with required medical, dental and immunizations for CPC clients.
• Conduct planning of specialized service management for youth transitioning from the child welfare system, including but not limited to, participation in routine integrated care team staffings and the coordination of services listed in the transition plan.
• Participate as requested in Sunshine Health’s case management integrated care team and multi-disciplinary care team (MDT) staffings.
• Participates in the agency strategic plan & quality improvement processes.
• Ability to safely & successfully perform essential job functions consistent with the ADA, FMLA, & other federal, state, & local standards, including meeting qualitative & quantitative productivity standards.
• Ability to maintain reasonably regular, punctual attendance consistent with ADA, FMLA & other federal, state, & local standards
• Duties as assigned in support of Sunshine Health.

Experience/Performance Requirements

• REQUIRED: Registered Nurse (RN)
• Minimum of 2 years of nursing experience, preferably in the child welfare or behavioral health care setting.
• Knowledge Medicaid funding available to children involved in the dependency system
• Experience working with the Department of Children and Families and/or the Agency for Health Care Administration
• Registered Health Information Administrator (RHIA), Certified Professional in Healthcare Management (CPHM), Licensed Healthcare Risk Manager and/or Certified Professional in Healthcare Quality (CPHQ)

General Information

• The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.
• This job description should not be construed to constitute contractual obligations of any kind or a contract of employment between Community Partnership for Children and any employee. Employment at Community Partnership for Children is “at-will” and either party can terminate the employment relationship at any time, with or without just cause.