OPS MEDICAL CASE MANAGER - 67980006

State of Florida • Alachua, FL

8d • $25 • Remote

About The Position

This is a professional position responsible for medical case management and consultation throughout the Region. The incumbent works in an interdisciplinary fashion within the construct of the regional structure. Primary duties include, but are not limited to, clinical oversight of medical case reviews, medication administration training and monitoring, ICF/IID admissions, eligibility reviews, and other health related quality controls which will require some travel to community locations. Works collaboratively with state office nursing/clinical team regarding the health and safety of Agency clients.

Requirements

• Bachelor of Science in Nursing is preferred.
• Must have a valid Driver’s License or other efficient means of transportation to travel for work purposes and willing to travel.
• Minimum 2 years of Registered Nursing experience.
• Knowledge of: Individuals with development/intellectual disabilities preferred.
• Case management and medical record reviews.
• Ability to: Create and maintain Excel Spreadsheets.
• Demonstrate Skills in: Microsoft Office, including Outlook, PowerPoint, and Teams.
• Effective written and verbal communication skills.

Responsibilities

• Serves as medical case manager to provide training for the provision of services outlined in the Medication Administration Rule FAC 65G-7, and monitors compliance. Responsibilities include but are not limited to coordination of approved Medication Administration trainers, monitoring compliance in licensed group/foster homes, and providing technical assistance to waiver support coordinators, supported living coaches, Adult Day Training (ADT), providers, and regional office staff. Attends local Children’s Medical Assessment Team (CMAT) meetings.
• Serves as coordinator for consumer health-related service requests. Responsibilities may include but are not limited medical case management reports, Special Medical Home Care recommendation, Significant Additional Needs requests, Skilled Nursing Exception Letters, medical review and Incident Management System reporting for illness, injury, or accident.
• Performs all ICF/IID facility admissions review to determine level of reimbursement and completes Facility Notification Regarding Day One Letter. Provides annual choice counseling for consumers residing in ICFs. Completes medical reviews for consumers transitioning out of the DDCs that require medical follow up, at 14 days and 90 days after transition.
• Completes all reports of death per requirement, and mortality reports upon request. Conducts SAO’s annual monitoring and data reporting as appropriate.
• Participates in Agency Hearings, meetings, and client staffing. Provides consultation for Medicaid exception denial requests and eligibility reviews as needed.
• Performs additional duties as required.

Benefits

• Annual and Sick Leave benefits.
• Nine paid holidays and one Personal Holiday each year.
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
• Retirement plan options, including employer contributions (For more information, please click www.myfrs.com).
• Flexible Spending Accounts.
• Tuition waivers.
• Paid Maternity and Parental Leave.

What This Job Offers

• Career Level: Mid Level