Care Coordinator Manager- Pediatrics

University of Maryland Faculty Physicians•Baltimore, MD

About The Position

The Care Coordinator Manager- Pediatrics role involves developing, appraising, and updating protocols and procedures for the Care Coordination/Transitional Care Management Program. This position integrates and evaluates program components into the patient care setting, tracks outcomes using electronic tools, and collaborates with various external entities (acute care facilities, hospitals, specialist offices, home health agencies, pharmacies, DME companies, insurance providers) to improve service coordination, patient outcomes, and satisfaction. The manager also collaborates with internal departments (Practice Operations, IT, Finance, Billing) to balance resource utilization and reimbursement, and with Practice/Call Center Managers and clinical staff to meet patient needs during transitions from acute care. Additionally, this role involves supporting and managing the Care Coordination/Transitional Care Management program staff, engaging with payers, completing home visit assessments, fulfilling reporting requirements, and participating in quality improvement activities and organizational/community committees. Compliance with mandatory training and requirements is also essential.

Requirements

Bachelor’s Degree in Nursing required.
Current Maryland licensure or eligibility to obtain Maryland licensure.
Minimum of 5 years clinical nursing experience.
Experience in acute care, home health, or ambulatory care.
Knowledge of managed care, discharge planning, utilization, and case management is required.
Knowledge of available community resources.

Nice To Haves

Certified Case Manager (CCM) preferred.

Responsibilities

Develops, appraises, and updates protocols and procedures relating to the Care Coordination/Transitional Care Management Program.
Integrates and evaluates the Care Coordination/Transitional Care Management program components into the patient care setting.
Tracks and monitors outcomes utilizing electronic populations management tools.
Collaborates with acute care facilities, hospitals, specialist offices, home health agencies, pharmacies, DME companies, insurance providers, etc. in the development of processes that seek to improve coordination of services as well as patient outcomes and satisfaction.
Collaborates effectively with FPI Practice Operations, Information Technology Management, Finance, and Billing Departments on the development of processes that effectively balance the utilization of resources with the maximization of reimbursement opportunities for Care Coordination/Transitional Care Management services.
Collaborates effectively with Practice/Call Center Managers, Back and Front Office Supervisors, and clinical site staff in the development of efficient processes that strive to meet with physical, educational, and psychosocial needs of Family Medicine patients transitioning out of an acute care setting.
Collaborates effectively with the Referral and Call Center Management Team on the development of processes that effective coordinate inpatient and outpatient consults and follow up appointments to reduce duplication and delay of services.
Supports the Care Coordination/Transitional Care Management program staff including training and orientation, planning, addressing complaints, resolving problems, and promoting cooperation and team work.
Engages with payers, case managers, and utilization management team to ensure coordination of care.
Completes home visit assessments for care coordination/transitioning patients as needed.
Completes internal and external reporting requirements as necessary.
Participates in QI activities towards a patient centered care environment that contributes to improvement in the patient experience as reported by Press Ganey surveys and other measures from the quality dashboard.
Participates in organizational and community committees as appropriate.
Completes mandatory employee health, workers compensation, HR processes and other training and requirements in required time frame to insure compliance with all FPI rules and regulations.