Medical Case Manager
About The Position
This professional Career Service position provides medical case management and consultation throughout the region, working within an interdisciplinary regional structure. The role provides clinical oversight of medical case reviews, medication administration training and monitoring, ICF/IID admissions and eligibility reviews, and other health-related quality controls. Some travel to community locations is required. The Medical Case Manager collaborates with the state office nursing and clinical team on the health and safety of Agency clients. The position provides training and monitors compliance with the Medication Administration Rule (FAC 65G-7), coordinates approved medication administration trainers, and provides technical assistance to waiver support coordinators, supported living coaches, Adult Day Training providers, other providers, and regional office staff. It coordinates consumer health-related service requests, reviews and reports medical incidents, performs ICF/IID admissions and transition-related reviews, completes death and mortality reports, and participates in hearings, meetings, and client staffing. The position is not eligible for telework and must report to the APD office in the area it serves.
Requirements
- Minimum of 2 years of Registered Nursing experience.
- Valid driver’s license or other efficient means of transportation for work purposes, and willingness to travel.
- Ability to create and maintain Excel spreadsheets.
- Skills in Microsoft Office, including Outlook, PowerPoint, and Teams.
- Effective written and verbal communication skills.
Nice To Haves
- Bachelor of Science in Nursing is preferred.
- Knowledge of individuals with developmental/intellectual disabilities is preferred.
- Knowledge of case management and medical record reviews.
Responsibilities
- Provide training on services under the Medication Administration Rule (FAC 65G-7) and monitor compliance.
- Coordinate approved Medication Administration trainers and monitor compliance in licensed group and foster homes.
- Provide technical assistance to waiver support coordinators, supported living coaches, Adult Day Training providers, other providers, and regional office staff.
- Attend local Children’s Medical Assessment Team (CMAT) meetings.
- Coordinate consumer health-related service requests, including medical case management reports, Special Medical Home Care recommendations, Significant Additional Needs requests, Skilled Nursing Exception Letters, and medical reviews.
- Report illness, injury, or accident information in the Incident Management System.
- Review all ICF/IID facility admissions to determine level of reimbursement and complete Facility Notification Regarding Day One Letters.
- Provide annual choice counseling for consumers residing in ICFs.
- Complete medical reviews for consumers transitioning out of DDCs who require follow-up, at 14 and 90 days after transition.
- Complete required reports of death and mortality reports upon request.
- Conduct SAO annual monitoring and data reporting as appropriate.
- Participate in Agency hearings, meetings, and client staffing.
- Provide consultation for Medicaid exception denial requests and eligibility reviews as needed.
- Perform additional duties as required.
Benefits
- Annual and sick leave.
- Nine paid holidays and one personal holiday each year.
- State Group Insurance options, including health, life, dental, vision, and supplemental insurance.
- Retirement plan options, including employer contributions.
- Flexible Spending Accounts.
- Tuition waivers.
- Paid maternity and parental leave.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
