Manager of Outpatient Care Management

MAXhealth • Sarasota, FL

1d • Hybrid

About The Position

MaxHealth is seeking a strong Manager of Outpatient Care Management will provide strategic and operational leadership for outpatient case management services across primary care settings. This role ensures high-quality, patient centered care coordination. Oversight of Care Management staff responsible for patient care coordination. Provides proactive planning and development of population health tools and care management programs that optimizes quality of care, clinical outcomes, utilization, and patient satisfaction. Conducts daily interactions in a manner that demonstrates a positive and organized attitude and effectively models the organizations service philosophy and values. Position can be fully remote/hybrid, but candidates must reside in the state of FL, GA, KY, NC, NV, PA, SC, TN, TX, VA, or WI. Compensation Based on Experience and Qualifications Typical work hours are Monday - Friday 8:00am to 5:00 pm with some flexibility. MaxHealth is dedicated to simplifying healthcare and ensuring healthier futures. Founded in 2015, MaxHealth is a leading primary care platform focused on providing high-quality, integrated care to adults and senior patients throughout Florida. We provide care for more than 120,000 patients, most of which are beneficiaries of government-sponsored healthcare programs like Medicare, or of health plans purchased on the Affordable Care Act exchange marketplace. MaxHealth is a rapidly growing medical practice with more than 50 clinics spread across central and southern Florida. MaxHealth also partners with independent providers who are like-minded and utilizes its platform to help them provide high-quality care. We are customer-centered; compassionate; results-driven; proactive; collaborative; and adaptable in executing our vision to help patients live their best lives. Our mission is to deliver quality care, a simplified experience, and happiness. One patient at a time. #IND123

Requirements

• Licensure as an RN; or Degree in Social Work with current unrestricted license in the state of Florida.
• Bachelor's Degree preferred in health care related field with 3-5 years' experience in Managed Care, Value Based Care, and/or Case Management or Discharge Planning with previous leadership experience.
• Strong skills and experience in staff development and working with remote employees.
• Intermediate to advanced Knowledge of computer software programs including: Word, Outlook, Excel, EMR
• Must have at least 2 years Management experience

Responsibilities

• Clinical practice and leadership: Implement a care management program using AI risk stratification models and remote patient monitoring for patients who would benefit from care management.
• Directly manages outpatient Care Managers.
• Coordinate and integrate utilization functions with the VP Of Medical Management, CMO, Director of Care Management, Medical Director, Physicians, Practice Manager, and clinical team to assure that overall inpatient and outpatient utilization for the assigned offices is evaluated on an ongoing basis.
• Provides comprehensive review of trends to identify high risk patients and present opportunities to achieve cost effective care.
• Case and Disease Management functions: Daily oversight of programs for Care Management.
• Clinical oversight of Care Management team to assure workflows and processes are executed.
• Monitor and evaluate quality of services provided.
• Assure team identifies who would benefit from case and disease management.
• Assures team is comprehensively assessing patients for care opportunities and supports collaboration with treating physicians to develop care plans that meet patients' needs.
• Leadership and Interdisciplinary Team: Actively engaged with CMO, Medical Director, Physicians, Practice Managers, Hospitalists, Clinical Team for readmission prevention, improving health outcomes, addressing social determinants and treatment adherence, including transitions in care and post-acute needs.
• Collaborate and identify patient status: Uses remote patient monitoring tools and reviews patient portal to identify patients in need of treatment for outpatient care.
• Recommends appropriate care needs through cost effective alternatives and clinical review strategies.
• Will be highly engaged and share best practices for high-risk patients and champion the success of value-based care.
• Coordinate and Integrate Utilization functions: Will assure quality of care through performance improvement activities that enhance the outcomes of lead performance indicators of each clinic.
• Communicate gaps in open access to care and work to increase care to an optimal level with primary care providers and appropriate specialists.
• Makes data driven decisions and develops appropriate action plans for process improvement.
• Oversight of team performance of successful implementation of care models for targeted patients, as well as provide coaching, anticipatory guidance, and specific education of staff as needed.
• Collaborate with all providers and hospitalist on patient processes to access the appropriate level of care in the right setting.
• Develop tools and best practices for education of patients about self-management of conditions, medications, and adherence.
• Oversee performance standards of Care Management team and assist with education and training needs.
• Comply with organizational guidelines and health care laws and regulations.
• Provide coverage for other areas/ departments as needed
• Additional responsibilities as deemed necessary

What This Job Offers

• Job Type: Full-time
• Career Level: Manager