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Disease Management Clinician

Job Description

Job Title          : Disease Management Clinician


Location          : Tampa, FL – 33618


Shift Time        : 12 pm - 9 pm (eastern) primarily with potential to rotate to 11 am - 8 pm (eastern) occasionally based on business need.


Tentative Start Date :ASAP/ 2-weeks
Job Description:


The Disease Management Clinician is responsible for conducting disease management and any related case management and quality activities in accordance to Health Integrated’s policies and procedures.  The position responsibilities include the management and coordination of health and psychosocial care, education, referrals and services of assigned cases to ensure costs are contained and quality of care is maintained as the patient accesses care and services in the continuum of care.
Disease Management, according to the Disease Management Association of America (DMAA), is defined as a: “multi-disciplinary, coordinated, continuum-based approach to healthcare delivery and communications for populations with, or at risk for, established medical conditions.”


 


Job Responsibilities:


  • Thorough knowledge of Disease Management or Case Management functions

  • Strong communication, documentation, clinical and critical thinking skills and problem solving skills are essential;

  • Working knowledge of community resources and alternate funding resources;

  • Knowledge of entitlement programs and ability to access them;

  • Working knowledge of details/resources that are required to individualize a case, contain costs and maintain quality of care for persons with a catastrophic or high-cost illness or injury;

  • Strong skills in dealing with difficult and challenging personalities and situations are essential;

  • Ability to communicate and work with a multidisciplinary team (internal and external) to facilitate day-to-day workflow;

  • Ability to recognize and communicate any concerns or issues to DM Supervisor or Manager in a professional and timely manner;

  • Excellent typing and computer skills, and ability to collect data as assigned for reporting purposes;

  • Computer literacy, including familiarity with Windows and Microsoft Office programs.

  • Other duties as assigned



Customer Services-Internal


  • Creates and supports a positive and supportive working environment;

  • Identifies and resolves potential personnel/peer problems and issues proactively;

  • Communicates to DM Supervisor and/or Manager of DM/CM all problems, issues and/or concerns as they arise;

  • Maintains a courteous and professional attitude when working with all HI staff members and the management team;

  • Actively participates in any DM/CM team meetings;

  • Actively participates in any DM/CM committee meetings as assigned; and,

  • Serves as a positive role model for peers.


 


Customer Services-Internal/External


  • Works, communicates and collaborates in harmony and in a courteous and professional manner with patients, practitioners/providers, health purchaser clients and their staff, and the Health Integrated multidisciplinary team;

  • Timely processes and communicates, identifies and resolves all issues and concerns related to the day-to-day diseases and case management activities as assigned/designated;

  • Communicates appropriately and according to Health Integrated policy and/or regulatory requirements with the practitioners, providers, members or their legally appointed representatives, and/or the health purchaser’s DM/Member/Customer Services or claims staff regarding DM issues;

  • Serves as liaison and patient advocate for quality of care and cost outcomes; and,

  • Maintains a working knowledge of the health purchaser contracts and relevant regulatory requirements.



Qualifications:


  • Thorough knowledge of Disease Management or Case Management functions

  • Strong communication, documentation, clinical and critical thinking skills and problem solving skills are essential;

  • Working knowledge of community resources and alternate funding resources;

  • Knowledge of entitlement programs and ability to access them;

  • Working knowledge of details/resources that are required to individualize a case, contain costs and maintain quality of care for persons with a catastrophic or high-cost illness or injury;

  • Strong skills in dealing with difficult and challenging personalities and situations are essential;

  • Ability to communicate and work with a multidisciplinary team (internal and external) to facilitate day-to-day workflow;

  • Ability to recognize and communicate any concerns or issues to DM Supervisor or Manager in a professional and timely manner;

  • Excellent typing and computer skills, and ability to collect data as assigned for reporting purposes;

  • Computer literacy, including familiarity with Windows and Microsoft Office programs.

  • Regular, dependable attendance



Education:


Licensed healthcare professional (RN, LCSW) with current, unrestricted license required.


A Bachelors (or higher) degree in a health-related field preferred.


Disease Management certification preferred.
Work Experience Requirements:


2+ years clinical experience in case or disease management in a managed care environment; 2+ years


 in community nursing or medical social work. 2+ years full-time direct clinical or critical care to


patients in a medical/surgical or behavioral health setting; or 2+ years of experience in applying
healthcare criteria or a behavioral health set of criteria. Call center knowledge desirable

Job Requirements


•         Training will be remote 



•         Must have managed care exp



•         Must be a RN or LCSW



•         Experience working remotely 



•         Hardwire internet connection (no wifi)



•         Must have Disease Management exp 

Job Snapshot

Location US-FL-Tampa
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Health Care
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Company Overview

American Cybersystems, Inc. (ACS Group)

ACS Group provides services to Fortune 1000 companies across various industry verticals. With a proven track record of managing project demands while improving the efficiency, productivity and profitability of new and existing projects through process improvement, ACS Group is consistently recognized for identifying and implementing strategic solutions that create and preserve long-term business value. Learn More

Contact Information

US-FL-Tampa
Sushma Sonam
678-606-0218
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Snapshot
American Cybersystems, Inc. (ACS Group)
Company:
US-FL-Tampa
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description

Job Title          : Disease Management Clinician


Location          : Tampa, FL – 33618


Shift Time        : 12 pm - 9 pm (eastern) primarily with potential to rotate to 11 am - 8 pm (eastern) occasionally based on business need.


Tentative Start Date :ASAP/ 2-weeks
Job Description:


The Disease Management Clinician is responsible for conducting disease management and any related case management and quality activities in accordance to Health Integrated’s policies and procedures.  The position responsibilities include the management and coordination of health and psychosocial care, education, referrals and services of assigned cases to ensure costs are contained and quality of care is maintained as the patient accesses care and services in the continuum of care.
Disease Management, according to the Disease Management Association of America (DMAA), is defined as a: “multi-disciplinary, coordinated, continuum-based approach to healthcare delivery and communications for populations with, or at risk for, established medical conditions.”


 


Job Responsibilities:


  • Thorough knowledge of Disease Management or Case Management functions

  • Strong communication, documentation, clinical and critical thinking skills and problem solving skills are essential;

  • Working knowledge of community resources and alternate funding resources;

  • Knowledge of entitlement programs and ability to access them;

  • Working knowledge of details/resources that are required to individualize a case, contain costs and maintain quality of care for persons with a catastrophic or high-cost illness or injury;

  • Strong skills in dealing with difficult and challenging personalities and situations are essential;

  • Ability to communicate and work with a multidisciplinary team (internal and external) to facilitate day-to-day workflow;

  • Ability to recognize and communicate any concerns or issues to DM Supervisor or Manager in a professional and timely manner;

  • Excellent typing and computer skills, and ability to collect data as assigned for reporting purposes;

  • Computer literacy, including familiarity with Windows and Microsoft Office programs.

  • Other duties as assigned



Customer Services-Internal


  • Creates and supports a positive and supportive working environment;

  • Identifies and resolves potential personnel/peer problems and issues proactively;

  • Communicates to DM Supervisor and/or Manager of DM/CM all problems, issues and/or concerns as they arise;

  • Maintains a courteous and professional attitude when working with all HI staff members and the management team;

  • Actively participates in any DM/CM team meetings;

  • Actively participates in any DM/CM committee meetings as assigned; and,

  • Serves as a positive role model for peers.


 


Customer Services-Internal/External


  • Works, communicates and collaborates in harmony and in a courteous and professional manner with patients, practitioners/providers, health purchaser clients and their staff, and the Health Integrated multidisciplinary team;

  • Timely processes and communicates, identifies and resolves all issues and concerns related to the day-to-day diseases and case management activities as assigned/designated;

  • Communicates appropriately and according to Health Integrated policy and/or regulatory requirements with the practitioners, providers, members or their legally appointed representatives, and/or the health purchaser’s DM/Member/Customer Services or claims staff regarding DM issues;

  • Serves as liaison and patient advocate for quality of care and cost outcomes; and,

  • Maintains a working knowledge of the health purchaser contracts and relevant regulatory requirements.



Qualifications:


  • Thorough knowledge of Disease Management or Case Management functions

  • Strong communication, documentation, clinical and critical thinking skills and problem solving skills are essential;

  • Working knowledge of community resources and alternate funding resources;

  • Knowledge of entitlement programs and ability to access them;

  • Working knowledge of details/resources that are required to individualize a case, contain costs and maintain quality of care for persons with a catastrophic or high-cost illness or injury;

  • Strong skills in dealing with difficult and challenging personalities and situations are essential;

  • Ability to communicate and work with a multidisciplinary team (internal and external) to facilitate day-to-day workflow;

  • Ability to recognize and communicate any concerns or issues to DM Supervisor or Manager in a professional and timely manner;

  • Excellent typing and computer skills, and ability to collect data as assigned for reporting purposes;

  • Computer literacy, including familiarity with Windows and Microsoft Office programs.

  • Regular, dependable attendance



Education:


Licensed healthcare professional (RN, LCSW) with current, unrestricted license required.


A Bachelors (or higher) degree in a health-related field preferred.


Disease Management certification preferred.
Work Experience Requirements:


2+ years clinical experience in case or disease management in a managed care environment; 2+ years


 in community nursing or medical social work. 2+ years full-time direct clinical or critical care to


patients in a medical/surgical or behavioral health setting; or 2+ years of experience in applying
healthcare criteria or a behavioral health set of criteria. Call center knowledge desirable

Job Requirements


•         Training will be remote 



•         Must have managed care exp



•         Must be a RN or LCSW



•         Experience working remotely 



•         Hardwire internet connection (no wifi)



•         Must have Disease Management exp 

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