Disease Management Case Manager jobs in West Palm Beach, FL

Job Summary

The VP of Case & Disease Management is responsible for the strategic development and oversight of the case and disease management team, which includes short and long-term case managers and the managers of each respective team. Additional responsibilities include clinical education and training, leadership development, KPI and quality assurance measures oversight, and chart audits. Provide leadership, strategy, and vision along with feedback, guidance and corrective action as needed, for the case & disease management department.

Essential Job Functions

Evaluate patient care data to ensure that care is provided in accordance with clinical guidelines and CMS standards.

Work cross-functionally with other departments and with vendors.

Communicate timely and effectively with medical staff, physicians, and beneficiaries to contribute to the development and improvement of clinical outcomes and cost effectiveness.

Develop and implement policies, procedures, and workflows as needed, per change and or new programs created for the case and disease management beneficiaries and team.

Tracks and monitors performance measures, ensuring appropriate accountability measures are in place and utilized.

Assess for appropriate staffing model to meet needs of beneficiaries, medical staff and organization.

Analyzes data sets to identify trends, opportunities and gaps and responds accordingly to address any needs.

Ensure beneficiary’s privacy, confidentiality and safety, advocacy, adherence to ethical, legal, and accreditation/regulatory standards during this process.

Participate in professional development activities to include current principles, procedures, and knowledge domains of case management based on nationally recognized standards and licensure requirements.

Performs other duties as assigned.

Skills and Competencies

• Working knowledge of medical terminology
• Excellent communication skills; verbal and written, and organizational skills
• Ability to utilize motivational Interviewing and solution-oriented approaches in communication delivery.
• Able to address conflict in a professional and effective manner
• Knowledge of electronic health records and practice management systems
• Proficient in Microsoft Office skills (Excel, Word, Access, etc.)
• Able to organize and lead ZOOM, Teams, WebEx, and other virtual meeting environments
• Ability to effectively communicate in English, both verbally and in writing
• Enjoys working in both individual and team settings
• Problem solver enjoys problem solving
• Self-starter, resourceful and able to execute projects in a fluid and fast paced environment
• Solid organizational, communication, and relationship skills
• Strong analytical skills
• High attention to detail

Education and Experience

• Active RN, BSN preferred
• Case Management Certification preferred
• 6 8 years case management / managed care experience
• 7 - 10 years of leadership experience
• Experience in customer service/relations-like roles

Physical Demands

• • Remote working environment
    • Potential travel required; approx. 10%
    • Prolonged periods of sitting at a desk

Additional Information

• • Must abide by all HIPAA, Confidentiality & Privacy Laws
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job

DISCLAIMER:

Job descriptions are not meant to be all-inclusive and/or the job itself is subject to change. Nothing in this job description restricts ilumed’s right to assign or reassign duties and responsibilities to this job at any time.