Care Manager - USFTGP UMSA Quality and Safety

Tampa General Hospital•Tampa, FL

About The Position

The Care Manager supports high-risk patients across the continuum of care and serves as a primary point of contact for patients and their multidisciplinary care teams. The role improves outcomes in ambulatory settings by identifying gaps in preventive and chronic disease management, reducing avoidable acute care utilization, and implementing individualized care plans. Working with USFTGP physician offices, the Care Manager supports quality performance, risk adjustment processes, and population health management. The position may include health coaching, chronic care management, Annual Wellness Visits, behavioral interviewing, and care transitions. The Care Manager collaborates with Accountable Care Organization (ACO) and value-based care initiatives, managed care partners, and community resources. The role requires autonomous work, strong communication and organizational skills, and a focus on providing an exceptional patient experience in remote and on-site settings as needed.

Requirements

Associate’s degree in nursing.
Registered Nurse license.
Minimum of five years of experience in a healthcare setting.
Chronic care or case management experience.
Understanding of chronic disease processes, preventive care guidelines, care coordination principles, and social determinants of health.
Ability to stratify patient populations, identify care gaps, and apply risk adjustment principles to support accurate coding and management of high-risk patients.
Strong verbal and written communication skills, including active listening and motivational interviewing, and ability to explain treatment regimens accessibly.
Ability to coordinate transitions of care, navigate community and ancillary resources, and resolve barriers to care for complex or high-risk patients.
Experience using electronic health records, such as Epic or Cerner, and comfort working remotely while maintaining professional standards and productivity.
Ability to function independently, manage multiple priorities, maintain accurate documentation, and keep team members and leadership informed of patient or workflow needs.

Nice To Haves

Ambulatory Care Nursing certification.
Telehealth Nursing Certification.
Case Management Certification.
Certified Professional in Healthcare Quality.

Responsibilities

Assess high-risk patients through Annual Wellness Visits, chronic care management evaluations, and needs assessments to identify care gaps and risk factors.
Provide clinical health coaching to support self-management of chronic conditions, lifestyle changes, and adherence to treatment plans.
Evaluate social determinants of health and connect patients with community resources.
Implement individualized, multidisciplinary plans of care to prevent avoidable emergency department visits, hospitalizations, and disease progression.
Coordinate transitions of care, including referrals, follow-up appointments, and communication with ancillary providers and community agencies.
Collaborate with primary care offices, ACO partners, and managed care staff to support value-based payment models and population health goals.
Use risk adjustment principles to stratify patient panels and manage high-risk populations.
Maintain thorough, timely electronic health record documentation and meet productivity and performance expectations.
Use behavioral interviewing and active listening to understand patient concerns, reduce resistance, and support positive health behaviors.
Work autonomously in remote and in-person settings and maintain communication with the provider care team, leadership, and care partners.