Care Coordinator Manager- Pediatrics- BA in Nursing required

University of Maryland Faculty Physicians; Baltimore (MD); On-site; USD 80,000 - 105,000; Full time

Job summary

University of Maryland Faculty Physicians is seeking a Care Coordination/Transitional Care Management professional to lead and coordinate care transitions for Family Medicine patients exiting acute settings.

You will develop protocols, collaborate with hospitals, clinics, payers, and IT, and track outcomes to improve patient experience and care continuity.

Qualifications

• Bachelor's Degree in Nursing required.
• Current Maryland licensure or eligibility to obtain Maryland licensure.
• Minimum of 5 years clinical nursing experience in acute care, home health, or ambulatory care.
• Knowledge of managed care, discharge planning, utilization, and case management.
• Knowledge of available community resources.

Responsibilities

• Develops, appraises, and updates protocols and procedures for Care Coordination/TCM.
• Integrates and evaluates program components into patient care setting.
• Tracks and monitors outcomes using electronic populations management tools.
• Collaborates with facilities, hospitals, offices, home health, and others to improve coordination and outcomes.
• Partners with Practice Operations, IT, Finance, and Billing to balance resources and reimbursement.
• Works with staff to meet physical, educational, and psychosocial needs during transitions.
• Supports staff, handles complaints, and promotes teamwork; engages payers and utilization teams.
• Completes home visit assessments and reporting requirements.
• Participates in QI activities and organizational committees.

Skills

Clinical nursing experience

Discharge planning

Case management

Managed care knowledge

Community resources knowledge

Education

Bachelor's Degree in Nursing

Job description

* Bachelor's Degree in Nursing required.

* Current Maryland licensure or eligibility to obtain Maryland licensure.

* Minimum of 5 years clinical nursing experience. Experience in acute care, home health,

or ambulatory care.

* Knowledge of managed care, discharge planning, utilization, and case management

is required.

* Knowledge of available community resources.

Develops, appraises, and updates protocols and procedures relating to the Care Coordination/Transitional Care Management Program.

Integrates and evaluates the Care Coordination/Transitional Care Management program components into the patient care setting.

Tracks and monitors outcomes utilizing electronic populations management tools.

Collaborates with acute care facilities, hospitals, specialist offices, home health agencies, pharmacies, DME companies, insurance providers, etc. in the development of processes that seek to improve coordination of services as well as patient outcomes and satisfaction.

Collaborates effectively with FPI Practice Operations, Information Technology Management, Finance, and Billing Departments on the development of processes that effectively balance the utilization of resources with the maximization of reimbursement opportunities for Care Coordination/Transitional Care Management services.

Collaborates effectively with Practice/Call Center Managers, Back and Front Office Supervisors, and clinical site staff in the development of efficient processes that strive to meet with physical, educational, and psychosocial needs of Family Medicine patients transitioning out of an acute care setting.

Collaborates effectively with the Referral and Call Center Management Team on the development of processes that effective coordinate inpatient and outpatient consults and follow up appointments to reduce duplication and delay of services.

Supports the Care Coordination/Transitional Care Management program staff including training and orientation, planning, addressing complaints, resolving problems, and promoting cooperation and team work. Engages with payers, case managers, and utilization management team to ensure coordination of care.

Completes home visit assessments for care coordination/transitioning patients as needed.

Completes internal and external reporting requirements as necessary.

Participates in QI activities towards a patient centered care environment that contributes to improvement in the patient experience as reported by Press Ganey surveys and other measures from the quality dashboard.

Participates in organizational and community committees as appropriate.

Completes mandatory employee health, workers compensation, HR processes and other training and requirements in required time frame to insure compliance with all FPI rules and regulations.

Total Rewards

The referenced base salary range represents the low and high end of University of Maryland Faculty Physician's Inc. salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications. University of Maryland Faculty Physician's Inc. offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: https://www.umfpi.org/jobs/summary-employee-benefits.