MEDICAL CASE MANAGER - 67073597

State of Florida; Miami (FL); On-site; USD 36,000 - 72,000; Full time

Job summary

State of Florida's Agency for Persons with Disabilities seeks a Medical Case Manager to oversee clinical reviews, medication training, and eligibility determinations across the region. The role requires travel and coordinates with state nursing teams to ensure client health and safety.

The ideal candidate will have an RN background, strong communication skills, and the ability to manage complex case workflows with the ICF/IID framework and waiver processes.

Qualifications

• Bachelor of Science in Nursing is preferred.
• Must have a valid Driver’s License or other efficient means of transportation to travel for work purposes and be willing to travel.
• Minimum 2 years of Registered Nursing experience.

Responsibilities

• Provide medical case management and consult within the regional structure.
• Coordinate Medication Administration training and monitor compliance in licensed group/foster homes.
• Attend local CMAT meetings and provide technical assistance to waiver coordinators and regional staff.
• Perform ICF/IID facility admissions reviews to determine reimbursement levels.
• Complete mortality and death-related reporting and participate in annual monitoring and data reporting.

Skills

Verbal communication

Written communication

Education

Bachelor of Science in Nursing

Tools

Microsoft Office

Job description

Requisition No:882744

Agency: Agency for Persons with Disabilities

Working Title: MEDICAL CASE MANAGER - 67073597

Position Number:67073597

Salary: $35,899.44 to $72,491.64 Annually

WORKING TITLE: MEDICAL CASE MANAGER

POSITION NUMBER: 67073597

OPEN COMPETITIVE OPPORTUNITY

This posting may close before the posted closing date.

CANDIDATE POOL: Future vacancies may be filled from this advertisement for a period of up to six months.

This position is not a Telework position and is required to report to the APD office in the area it serves.

The Benefits of Working for the State of Florida

Working for the State of Florida is more than a paycheck. The State’s total compensation package for eligible employees features a highly competitive set of employee benefits, including:

• Annual and Sick Leave benefits.
• Nine paid holidaysand onePersonal Holiday each year.
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
• Retirement plan options, including employer contributions (For more information, please click www.myfrs.com ).

The Agency seeks team members who demonstrate the qualities of being humble, hungry, and smart and lead others to embody the same. This entails lacking excessive ego, sharing credit, being self-motivated, and exercising good judgment and intuition regarding the subtleties of group dynamics.

This position with APD will serve staff and management across the Agency. Your work will impact the workplace culture, our community, and the population we serve as we continuously strive to achieve the Agency’s mission.

SALARY RANGE

$ 35,899.44- $72,491.64 Annually $1,380.74 - $2,788.14 Bi-weekly

Position Summary

This is a professional Career Service position responsible for medical case management and consultation throughout the Region. The incumbent works in an interdisciplinary fashion within the construct of the regional structure. Primary duties include, but are not limited to, clinical oversight of medical case reviews, medication administration training and monitoring, ICF/IID admissions, eligibility reviews, and other health related quality controls which will require some travel to community locations. Works collaboratively with state office nursing/clinical team regarding the health and safety of Agency clients.

The Work You Will Do

Serves as medical case manager to provide training for the provision of services outlined in the Medication Administration Rule FAC 65G-7, and monitors compliance. Responsibilities include but are not limited to coordination of approved Medication Administration trainers, monitoring compliance in licensed group/foster homes, and providing technical assistance to waiver support coordinators, supported living coaches, Adult Day Training (ADT), providers, and regional office staff. Attends local Children’s Medical Assessment Team (CMAT) meetings.

Serves as coordinator for consumer health-related service requests. Responsibilities may include but are not limited medical case management reports, Special Medical Home Care recommendation, Significant Additional Needs requests, Skilled Nursing Exception Letters, medical review and Incident Management System reporting for illness, injury, or accident.

Performs all ICF/IID facility admissions review to determine level of reimbursement and completes Facility Notification Regarding Day One Letter. Provides annual choice counseling for consumers residing in ICFs. Completes medical reviews for consumers transitioning out of the DDCs that require medical follow up, at 14 days and 90 days after transition.

Completes all reports of death per requirement, and mortality reports upon request. Conducts SAO’s annual monitoring and data reporting as appropriate.

Participates in Agency Hearings, meetings, and client staffing. Provides consultation for Medicaid exception denial requests and eligibility reviews as needed.

Performs additional duties as required.

Minimum Qualifications

• Bachelor of Science in Nursing is preferred.
• Must have a valid Driver’s License or other efficient means of transportation to travel for work purposes and be willing to travel.
• Minimum 2 years of Registered Nursing experience.

Knowledge, Skills, And Abilities

Knowledge of:

• Individuals with development/intellectual disabilities preferred.
• Case management and medical record reviews.

Ability to:

• Create and maintain Excel Spreadsheets.

Demonstrate Skills in:

• Microsoft Office, including Outlook, PowerPoint, and Teams.
• Effective written and verbal communication skills.

Additional Information

Profile Completion

To qualify for this position, applicants must complete all fields in the Candidate Profile, including their work history with the month and year.

Resumes and other documentation can be attached to provide additional information but will not replace the required completed Candidate Profile.

Retiree Notice

If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be suspended or voided, and you will be required to repay all benefits received depending upon your retirement date.

Direct Deposit Program

As a condition of employment, a person appointed to a position in the State Personnel System is required to participate in the Direct Deposit Program. Rather than receiving a paper paycheck, your funds will be deposited directly into your account at your financial institution. This will be accomplished by Electronic Funds Transfer. Banks, savings and loan associations, and credit unions are eligible to accept such deposits. Retirement funds are also required to be in the Direct Deposit Program.

It is the policy of the Florida Agency for Persons with Disabilities that applicants for employment undergo Level 2 employment screening in accordance with the requirements of Chapter 435, Florida Statutes, as a condition of employment or being permitted to serve as a volunteer.

No applicant for a designated position will be employed or permitted to volunteer until the Level 2 screening results are received, reviewed, and approved by the Agency.
Level 2 background screening shall include, but not be limited to, fingerprinting for Statewide criminal and juvenile records checks through the Florida Department of Law Enforcement and Federal criminal records checks through the Federal Bureau of Investigation and may include local criminal records checks through local law enforcement agencies.

Pursuant to S. 110.1127(1), Florida Statutes, this position requires a background investigation, including fingerprinting.

APD only hires U.S. citizens and those lawfully authorized to work in the U.S. APD participates in the U.S. government’s employment eligibility verification program (E-Verify), which electronically confirms an employee’s eligibility to work in the U.S. after completing the employment eligibility verification form (I-9).

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

VETERANS’ PREFERENCE.

Pursuant to Chapter 295, Florida Statutes,candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements.Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here . All documentation is due by the close of the vacancy announcement.

For assistance, call the People First Service Center at [phone] Monday - Friday, 8:00 a.m. to 6:00 p.m., Eastern time. Pursuant to Florida Law, 110.211 F. S., the State of Florida is an EEO employer.