Care Manager

Description

Introduction

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Care Manager opening with HCA Healthcare today and find out what it truly means to be a part of the HCA Healthcare team.

Job Summary and Qualifications

The Care Manager supports the patient and primary care relationship through care delivery enhancement. Primary mechanisms for this support are telephonic outreach to patients to guide them through transitions of care, care management, preventive services, and self-management. The Care Manager acts as an integral member of the division Care Coordination team supporting PSG primary care providers and practices in successfully meeting quality improvement initiatives in assigned division(s).

What you will do in this role:

General

• Serves as a subject matter expert in quality and value-based care programs such as MIPS, ACOs, and payor pay-for-performance contracts. Assists in educating practice staff on quality, payor, and government program requirements
• Develops professional working relationship with HCA/PSG primary care providers, practice managers, and their staff to collaboratively manage follow-up care and improve overall health and wellness
• Assists in the development of tools, education and workflow processes to assist the division(s) in meeting CMS, ACO, documentation, and payor quality initiatives
• Collaborates with interdisciplinary teams and leaders (PSG, Payer Contracting & Alignment, Quality and Payor Initiatives) to achieve the organization’s coordination of care goals, quality goals, and financial performance goals
• Conducts in-person and virtual meetings with practice managers, staff, providers and managers to communicate program goals, results, and provide education

Care Gaps

• Monitors patient compliance with preventive screening and/or behavioral health management processes using internal and payor reporting tools
• Accesses portals as necessary to prepare reports and other documents to evaluate progress and prioritize workload
• Communicates via telephone and other virtual tools with patients regarding care needs, documenting communications appropriately in the electronic medical record
• Prepares and maintains patient charting as needed and performs medical record reviews for payor projects
• Assists in securing and submitting necessary documentation for annual patient assessment forms (PAFs)
• Understands and addresses short term behavioral health care gaps as needed

Transitions of Care

• Contacts patients after an emergency department encounter or hospital discharge to identify the need for a follow-up appointment, community resource needs, etc.
• Documents assessment in the medical record to support transition of care services as specified by CMS and other program requirements

Care Management

• Triages patients to determine those appropriate for medical and/or behavioral care management
• Creates a care management action plan with the patient/caregiver that includes elements of self-management, as appropriate
• Identifies and enrolls eligible patients in longitudinal or chronic care management for medical or behavioral health conditions
• Oversees the execution of patient care plans in partnership with Care Coordinators
• Facilitates specialty referrals, as appropriate, for conditions/needs managed outside the primary care realm

Population Health

• Assists with practice and provider empanelment processes
• Schedules appointments related to preventive care, chronic disease management, and/or integrated behavioral health
• Prepares and maintains care coordination reports and provides periodic updates to practice leaders and providers

What Qualifications you will need:

• Graduate of an accredited college of nursing or social work required
• Knowledge of physician office practice operations and one (1) year of experience in a physician practice is preferred
• Current licensure as an RN in the state of residence and/or practice or current licensure as a Social Worker in state of residence and/or practice

Benefits

HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

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Physician Services Group is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170 urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcares commitment to the care and improvement of human life.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

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"Across HCA Healthcare’s more than 2,000 sites of care, our nurses and colleagues have a positive impact on patients, communities and healthcare.
Together, we uplift and elevate our purpose to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN
Senior Vice President and Chief Nursing Executive

If you find this opportunity compelling, we encourage you to apply for our Care Manager opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing apply today!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.