Case Manager, Value Based

Tampa Family Health Centers; Tampa (FL); Sur place; USD 60 000 - 85 000; Plein temps

Avantages offerts par ce poste

Medical, Dental & Vision Insurance

Life & Disability Insurance

PTO & holidays

401(k) with employer contribution

Professional development

Résumé du poste

Tampa Family Health Centers seeks a Value-Based Case Manager to advance care coordination and outcomes for patients enrolled in ACO and managed care plans.

The role emphasizes proactive outreach, data-driven quality improvement, and collaboration with care teams to implement evidence-based protocols for primary care patients. RN license in Florida is required, ADN required with BSN preferred.

Qualifications

• 1–2 years in care management within primary health care or managed care.
• ADN is required; BSN preferred; RN licensed in Florida.

Responsabilités

• Support strategies to reduce unnecessary healthcare utilization while ensuring high-quality patient-centered care.
• Track utilization patterns, care gaps, and outcomes for assigned patients.
• Identify and prioritize patients impacting quality, utilization, and cost outcomes.
• Prepare charts to support value-based priorities and referrals.
• Review medical records to abstract data for value-based reporting.
• Document findings in value-based databases and cloud platforms.
• Attend meetings with carriers to review plan data and improve outcomes.
• Present value-based data reports to the Executive VP of Value Based Services.
• Train healthcare professionals on value-based compliance.
• Establish patient follow-up schedules and monitor progress in the EHR.
• Monitor discharge reports to connect patients with appropriate care.
• Outbound/inbound calls to high-risk, chronic patients.
• Meet with patients/families to assess needs and goals.
• Use educational materials and resources to motivate behavior change.

Connaissances

Case management principles

Clinical quality indicators

Microsoft Office & EHR

Communication skills

Analytical evaluation

Organizational skills

Formation

Associate Degree in Nursing (ADN)

Bachelor of Science in Nursing (BSN)

Florida RN license

Outils

EHR

Description du poste

Location: Remote, with occasional in-office attendance as required
Organization: Tampa Family Health Centers
Position Type: Full-Time, Non-Exempt

Case Manager, Value Based

Location: Remote, with occasional in-office attendance as required
Organization: Tampa Family Health Centers
Position Type: Full-Time, Non-Exempt

About Tampa Family Health Centers

At Tampa Family Health Centers, healthcare is more than a service—it’s our mission. As a Federally Qualified Health Center, we provide high-quality, compassionate, and accessible healthcare to a culturally diverse community across Hillsborough County.

Joining TFHC means becoming part of a mission-driven organization where every team member plays a vital role in supporting exceptional patient care and improving the healthcare experience for the communities we serve.

Position Summary

The Value-Based Case Manager plays a critical role in advancing Tampa Family Health Centers’ value-based care strategy by improving clinical outcomes, reducing total cost of care, and supporting quality performance for Accountable Care Organizations (ACO) and managed care plans.

This position focuses on proactive patient outreach, care coordination, and performance improvement aligned with HEDIS, STARS, and other quality adherence measures. The Value-Based Case Manager works collaboratively as part of the care team to implement evidence-based protocols for primary care patients.

Essential Responsibilities

• Support strategies to reduce unnecessary healthcare utilization while ensuring high-quality, patient-centered care.
• Track and analyze utilization patterns, care gaps, and outcomes for assigned patient populations.
• Identify and prioritize patients who impact quality, utilization, and cost outcomes.
• Complete chart preparation to facilitate completion of Value-Based Services priorities, including care gaps, referrals, and laboratory ordering.
• Review electronic and hard-copy medical records and supporting documentation to abstract clinical data for value-based reporting.
• Document findings in applicable value-based databases and prescribed cloud-based platforms.
• Attend regular meetings with assigned carriers to review plan data and develop strategies to improve outcomes for patient cohorts.
• Prepare and present value-based data reports to the Executive Vice President of Value Based Services.
• Train and advise healthcare professionals and clinical and administrative staff regarding value-based compliance.
• Establish patient follow-up schedules and monitor patient progress using electronic care management tracking systems within the Electronic Health Record (EHR).
• Monitor ENS and hospital discharge reports to facilitate patients' connection with appropriate care.
• Conduct inbound and outbound telephone outreach to patients identified as having high-risk, chronic, and complex care needs.
• Meet with patients and/or supportive family members or responsible parties to assess current needs and barriers and establish patient-directed, measurable goals.
• Utilize educational materials, brief intervention techniques, and community resources to engage patients, increase motivation for change, and assist patients in establishing and implementing behavior-change goals.
• Perform other duties as assigned.

Qualifications

• One to two (1–2) years of experience in care management, case management, or population health within a Primary Health Care organization and/or Managed Care non-clinical setting.
• Graduate of an accredited School of Nursing.
• Associate Degree in Nursing (ADN) required.
• Bachelor of Science in Nursing (BSN) preferred.
• Current Florida license as a Registered Nurse (RN).

Skills & Abilities

• Knowledge of case management principles, procedures, and practices.
• Knowledge of clinical quality indicators, including but not limited to HEDIS, STARS, MIPS, Meaningful Use, and UDS.
• Proficiency with Microsoft Office products, including Word, Excel, and PowerPoint, as well as Electronic Health Records (EHR).
• Ability to communicate and present ideas effectively in both written and verbal formats.
• Ability to conduct detailed analytical evaluations and studies and prepare related reports and recommendations.
• Strong organizational, communication, care coordination, and patient-engagement skills.
• Ability to collaborate effectively with clinical, administrative, managed care, and value-based care teams.

Benefits & Rewards

TFHC offers a comprehensive benefits package designed to support your personal well-being and professional growth:

• Medical, Dental, and Vision Insurance.
• Life and Disability Insurance offerings.
• Generous PTO and paid company holidays.
• 401(k) program with employer contribution eligibility.
• Professional development opportunities.
• Mission-driven and collaborative work environment.

Please note that the employee’s initial training schedule may differ from the regular schedule of the position. All new hires, including part-time employees, must be available for up to 40 hours of in-person, on-site training during their first week. Additional mandatory training may continue for approximately two to three weeks, depending on the position and training requirements. Training may take place at a TFHC location other than the employee’s assigned work location.