Company: DaVita Medical Group
Location: Saint Petersburg
Posted on: August 15, 2019
OVERVIEW OF POSITION:Responsible for ensuring the continuity of
care in both the inpatient and outpatient setting utilizing the
appropriate resources within the parameters of established
contracts and patients' health plan benefits. Facilitates continuum
of patients' care utilizing advanced nursing knowledge, experience
and skills to ensure appropriate utilization of resources and
patient quality outcomes. Performs care management functions
on-site or telephonically as the need arises. Works in conjunction
with the care team and PCP as care team leader. Ensures evaluation
is in alignment with site based goals.ESSENTIAL FUNCTIONS:
- Consistently exhibits behavior and communication skills that
demonstrate DaVita Medical Group's Mission Vision and Values, and
commitment to superior customer service, including quality and care
and concern with each and every internal and external
- Represents the Company in a professional manner, following all
Company policies and procedures.
- Uses, protects, and discloses DaVita Medical Group patients'
protected health information (PHI) only in accordance with Health
Insurance Portability and Accountability Act (HIPAA)
- Ability to obtain CPR certification within 90 days of
employment (Basic Life Support for Healthcare providers (AHA) or
CPR/AED for the Professional Rescuer (American Red Cross).
- LPNs: Ability to obtain IV Certification within 90 days of
- Prioritizes patient care needs upon initial visit and addresses
- Meets with patients, patients' family and caregivers as needed
to discuss care and treatment plan as delineated in Transitions of
- Identifies and assists with the follow-up of high-risk patients
in acute care settings, skilled nursing facilities, custodial and
- Consults with physician and other team members to ensure that
care plan is successfully implemented.
- Coordinates treatment plans with the care team and triages
interventions appropriate to the skill set of the team
- Uses protocols and pathways in line with established disease
management and care management programs and approved by medical
management in order to optimize clinical outcomes.
- Monitors and coaches patients using techniques of motivational
interviewing and behavioral change to maximize
- Oversees provisions for discharge from facilities including
follow-up appointments, home health, social services,
transportation, etc., in order to maintain continuity of care.
- Works in coordination with the care team and demonstrates
accountability with patient management and outcome.
- Discusses Durable Power of Attorney (DPoA) and advanced
directive status with PCP when applicable.
- Maintains effective communication with the physicians, disease
management, hospitalists, extended care facilities, patients and
- Provides accurate information to patients and families
regarding plan benefits, community resources, referrals and other
- Documents pertinent patient information in Electronic Health
Record and FOCUS as appropriate.
- Demonstrates a thorough understanding of the cost consequences
resulting from Care Management decisions through utilization of
reports and systems such as Health Plan Benefits, utilization of
metrics and CM reports.
- Adheres to departmental policies and procedures as approved by
Best Practice Committee and QMOC (Quality Medical Oversight
- Ability to work collaboratively with the provider and care team
to carry out nursing interventions under proper scope of
- Performs additional duties as assigned.
- Ability to travel as necessary, or cover centers remotely,
based on business need.EDUCATION:
- High school graduate, GED or equivalent.
- Graduation from an accredited school of Nursing.
- Must possess a current and valid LPN or RN Florida state
- LPNs: IV Certification required.
- RNs: Associates or Bachelor's degree in Science required.
- Basic Life Support for Healthcare providers (AHA) or CPR/AED
for the Professional Rescuer (American Red
- Previous experience in an acute clinical care setting or
- Previous care management, utilization review or discharge
- One year experience in an acute clinical care setting
- Bachelor's degree in Nursing preferred.
- HMO experience preferred.KNOWLEDGE, SKILLS, ABILITIES:
- Knowledge of current standards of patient care.
- Thorough understanding of RN scope of practice and LPN scope of
- Ability to provide on-site clinical treatment within scope of
- Ability to perform accurate telephonic triages, accurately
record findings with follow-up.
- Knowledge and skill in the applications of the techniques and
practices of the nursing profession.
- Ability to explain medical instructions to patients and their
- Ability to make sound, independent judgments and act
professionally under pressure.
- Valid Florida driver's license, insurance and vehicle for
- Ability to learn and understand appropriate Federal, State, and
- Ability to effectively communicate and collaborate with
physicians, patients, families and ancillary staff.
- Ability to communicate effectively with patients and all levels
of personnel/customers in a professional, courteous and effective
manner using excellent customer service skills.
- Ability to be a clinical resource for non-licensed office
- Ability to prioritize and multi- task in a high paced
environment with good organizational skills.
- Display initiative, accountability and resourcefulness.
- Ability to perform care management.
- Must be computer literate.
- Knowledge of HIPAA regulations.
- Ability to read, speak, write, and understand the English
Keywords: DaVita Medical Group, St. Petersburg , Care Manager, Executive , Saint Petersburg, Florida
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