Nurse Care Specialist

Heartland for Children; Bartow (FL); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Tuition assistance

Domestic partner coverage

Retirement plan

Generous paid time off

Job summary

A child welfare organization in New York is seeking a Licensed Registered Nurse to coordinate medical care for dependent children on various health plans. Responsibilities include managing health assessments, attending medical staffings, and providing education to caregivers. Candidates should have a minimum of two years of nursing experience, preferably in child welfare. The role offers an excellent benefits package, including tuition assistance and generous paid time off.

Qualifications

• Minimum of two years of nursing experience, preferably in child welfare or behavioral health.
• Licensed Registered Nurse required.
• Ability to coordinate medical care for children in dependency.

Responsibilities

• Coordinate medical care service for dependent children.
• Establish relationships with internal and external customers.
• Ensure completion of Health Risk Assessments.
• Participate in medical staffings for children.
• Assist caregivers in obtaining necessary medical equipment.

Skills

Nursing experience

Care coordination

Patient assessment

Communication skills

Drug testing compliance

Education

Licensed Registered Nurse

Job description

This is a professional, licensed Registered Nurse position that will ensure the primary, medical care service coordination for dependent children on the Sunshine Health Pathway to Shine Plan and other MMA plans, 72-hour well-child checkups, monitor medical metrics and follow high risk/medically complex children.

Essential Functions:

Establishes and maintains positive working relationship with HFC internal and external customers

Assists in the coordination of medical care for children under dependency court supervision

Ensures that an initial Health Risk Assessment is completed on children and submitted to Sunshine Health

Participate in staffings for children who have been assessed, recommended or placed in medical foster care, deemed medically complex or fragile, who have ongoing medical or dental needs, which impact their care while in the dependency system.

Participate on child specific staffings, attend and facilitate trainings.

Report any identified issues to child welfare case management, Sunshine Health or health care plan and places appropriate referrals for medical case management

Follows up with case manager and/or caregiver following all emergency and inpatient admissions and document accordingly into Envolve Client portal regarding discharge follow up recommendations and to assess any physical health needs

Monitor enrollment status of children and confirm youth is enrolled onto the appropriate health plan

Alert HFC’s Resource Specialist when children who receive SSI benefits enter into licensed care

Process and submit Care Grants for children while ensuring the application is complete with accompanying documentation

Coordinate with REVMAX department in regards to appropriate demographic changes and report any identified Medicaid issues

Work closely with Sunshine Health regarding Healthcare Effectiveness Data and Information Set (HEDIS) measures

Serves as a consultant to case management on making timely, appropriate and effective referrals to medical care services

Assist Children’s Medical Services (CMS) caregivers in obtaining Durable Medical Equipment, locating appropriate providers and specialists. Participates in discharge planning and coordination with health care plan from inpatient services including the monitoring of post-discharge follow-up appointments and ordered services

Reviews the health and wellness reports, Florida Safe Families Network (FSFN) reports, Florida Shots, and other data sources for status of required annual physical, dental and vision screenings for children placed in out of home care and coordinate with child welfare case manager and/or caregivers as needed to ensure scheduling of needed appointments

Notify Sunshine Health on all pregnant members within 24 hours of discovery and refer for Sunshine Health pregnancy case management. Participate in monthly OB staffings with Sunshine Health

Perform and participate in other activities as assigned by Sunshine Health and HFC

Completes Sunshine Health TOC (transition of care) document and report any barriers or needs for medical case management

Coordinate and support the Central Florida Health Care mobile dental and vision screening services offered to children served by the child welfare system

Review care gaps and follow up with caregivers and/or case managers to ensure members are getting their required medical and dental services

Completes PCP (primary care physician) changes as needed and provide Medicaid ID cards

Obtain medical records to assist with continuity of care and to coordinate with caregivers and/or case managers regarding any additional services or needs Provide education as needed to caregivers and/or case managers regarding medical diagnoses, well exam and immunization schedule

Reviews Incident Reports and completes follow up with caregivers and/or case managers as needed

Performs special projects as assigned

Required Qualifications:

Licensed registered nurse.Minimum of two years of nursing experience preferably in the child welfare or behavioral health care setting

Excellent benefits package with tuition assistance, domestic partner coverage, retirement andgenerous paid time off.

Additional Information:

Drug free workplace. Drug testing required. EOE/M/F/D/V.