Gainesville, FL, Provider Liaison- Medical Assistant Temporary

Theoria Medical•Gainesville, FL

7h•Hybrid

About The Position

Theoria Medical is a physician-led post-acute care organization delivering value-based care in the skilled nursing facility (SNF) setting. Instead of asking patients to come to us, we bring high-quality, patient-centered care directly to them. We are leading the charge in healthcare innovation, bringing multispecialty provider services and forward-thinking technology to skilled nursing facilities across the country. We're looking for a Medical Assistant to join our post-acute care team on a temporary basis to serve as the vital connection between residents, providers, nursing staff, and families, coordinating care, facilitating telemedicine visits, and reinforcing patient education to drive better outcomes in a value-based care model.

Requirements

Graduate of an accredited Medical Assistant (MA) program
Prior experience as a Medical Assistant in a clinical or care-coordination setting
Superior interpersonal skills
Experience charting in an EMR
Detail orientation
Problem solving, thinking autonomously, and owning the solution
Professional demeanor
Knowledge of geriatric medical practice and terminology
Innovative mindset
History of successful outcomes or quality-driven practices
Commitment to ethical patient care
Teamwork and a can-do attitude
Advanced computer skills (e.g., Excel filtering and advanced features, Google/Gmail, etc.)
Strong communication skills (verbal and written)

Nice To Haves

Certified Medical Assistant (CMA) preferred
Health Plan / Hospice Liaison experience preferred
Managed Care experience preferred

Responsibilities

Facilitate in-room telemedicine visits and schedule acute, follow-up, and routine provider appointments
Prepare and support residents during provider visits, including positioning and documentation
Update EHRs with medical histories to support care plans and visit encounters
Support smooth transitions of care across the post-acute continuum, including referrals and follow-up appointments
Facilitate prior authorizations and assist residents with ACO Voluntary Alignment forms
Reinforce provider instructions and educate residents on nutrition, fall prevention, medication reminders, and general wellness
Distribute provider-approved materials and route clinical concerns to licensed staff or providers
Maintain accurate documentation in the EMR and support regulatory compliance and quality initiatives
Manages the Transition of Care process from admission to transition home (i.e., admission, discharge planning, and follow-up)
Monitors active patients across care settings (hospitals and SNFs)
Visits facilities (hospitals and SNFs) on a routine basis
Serves as a resource for the patient and their family to help solidify the discharge and treatment plan
Facilitates and clarifies the patient’s goals of care with the facilities and attending physicians
Assists with discharge planning from inpatient or skilled nursing settings
Works collaboratively with the clinical coordinator to ensure discharge data is appropriately documented and transition-of-care visits are scheduled and verified with the patient/family
Collaborate with the Community Medical Director daily to review the appropriateness of discharge plans
Reviews with the CMD the medical necessity of Home Health orders and DME orders, and follows up with those HH and DME agencies on their treatment plan
Facilitates access for patients to verify their ancillary services (e.g., DME, Home Health, outpatient rehab) are in place and meeting their needs
Attends Interdisciplinary Team (IDT) meetings and provides additional information on patients
Serves as the face of [Company Name] in the hospital/SNF when physicians cannot be onsite (e.g., bringing in notes, POLST, etc.); patients recognize them as part of the [Company Name] program
Assists physicians with communicating with the attending of record
Arranges family meetings in the SNF and hospital
Develops relationships in the admitting, ED, and Case Management departments in the facility setting
Coordinates with the facility’s Case Management and Social Work teams on the discharge
Develops relationships with SNF administrators
Obtains access to clinical records in the facility setting, and reviews and facilitates medical-records transfer to [Company Name]
May conduct home visits based on community team needs
Ability to explain the [Company Name] care model and engage new members into the program
Other tasks needed to accomplish the team’s objectives and goals