PinellasParkRecruiter
the smart solution for Pinellas Park jobs

Pediatric Care Specialist - LPN

Company: Wellcare
Location: Pinellas Park
Posted on: March 6, 2019

Job Description:

Pediatric Care Specialist - LPN Utilizes care coordination tools, criteria and protocols to provide care coordination to lower acuity members with acute and chronic health care needs. Provides education and support in assisting members to achieve optimal level of wellness. Works with member to support compliance with care and treatment plans in collaboration with the interdisciplinary care team. Reports to: Director, Field Care Management Department: Case Management - Health Services Location: New Port Richey, FL (Pasco, Pinellas) Essential Functions: Perform member interviews to assist with gathering of information Perform follow up with members engaged in case management Facilitate provider contact as needed to coordinate member's care needs. Initiates appropriate referrals and inputs authorizations as needed for members active in case management. Support the identification of high-risk members for disease or case management needs and works with member, physician and other Health care providers to meet the member's individual needs. Identifies and escalates member cases with complex medical needs to Supervisor or Manager. Act as liaison and member advocate between the member/family, physician and facilities/agencies. Coordinates community resources, with emphasis on medical, behavioral, and social services. Applies case management standards, maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality of care issues. Instructs the member on how to access the program resources, suggest and/ or arrange follow-up including mailing of educational materials, contact with community resources, facilitate physician visits. Documents all contacts in the Health Services clinical documentation system. Manage members in disease management program, completing and revising as necessary, the information in clinical documentation system. Ensures compliance with all state and federal regulations as well as Corporate guidelines in day-to-day activities. Meets with clients in their homes, work-sites, physician's or hospital to provide management of services. Adapts to changes in policies, procedures, new techniques and additional responsibilities. Participates with other Case Managers and Medical Directors in regular or special meetings such as Clinical rounds. Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable, and Corporate and department policies and procedures. Identifies potential quality of care issues and appropriately refers to the quality department. Assists in the implementation of specific strategies that improve the quality and outcomes of care. Educates members and facilitates HEDIS gap closure. Performs all other duties assigned. Works under direct supervision of a Registered Nurse Additional Responsibilities: Travel to inpatient bedside, member's home, provider's office, hospitals, etc required with dependable car. May spend up to 70% of time traveling with exposure to inclement weather and normal road hazards. May require climbing multiple flights of stairs to a member's home, provider's office, etc. Candidate Education: Required A High School or GED Preferred An Associate's Degree in nursing Candidate Experience: Required 2 years of experience in utilization management and/or case management in a hospital or home health setting or with a managed care organization. Preferred Other prior experience working with a geriatric population Required Other In the Florida market, 4 years in pediatric experience Required Other Work experience requirements may be waived for associates engaged in Florida's CMS contract that worked in a similar capacity for Florida's Department of Health in 2018. Candidate Skills: Intermediate Ability to drive multiple projects Intermediate Ability to multi-task Intermediate Ability to work in a fast paced environment with changing priorities Intermediate Ability to work independently Intermediate Demonstrated time management and priority setting skills Intermediate Demonstrated interpersonal/verbal communication skills Intermediate Other Ability to provide input to care/treatment plan Intermediate Demonstrated negotiation skills Intermediate Ability to effectively present information and respond to questions from families, members, and providers Intermediate Ability to implement process improvements Licenses and Certifications:A license in one of the following is required: Required Other Current unrestricted LPN/LVN state license Technical Skills: Required Intermediate Microsoft Excel Required Intermediate Microsoft Word Required Intermediate Microsoft PowerPoint Required Intermediate Microsoft Outlook Languages: Required-English Preferred-Spanish/GreekAbout usHeadquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at . EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.

Keywords: Wellcare, Pinellas Park , Pediatric Care Specialist - LPN, Healthcare , Pinellas Park, Florida

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Travel RN/Registered Nurse - Stepdown-Telemetry
Description: We have a great opportunity for a Step Down RN in Port Charlotte, Florida. This position is for Full
Company: PPR Travel Nursing
Location: Port Charlotte
Posted on: 03/22/2019

Registered Nurse - All Specialties Needed
Description: Employer has Contract and PRN opportunites available now for RNs in the following specialties: MED/SURG, TELE, ICU, ER, OR, L D and more... br br We offer the highest quality benefits in the healthcare (more...)
Company: Accountable Healthcare Staffing
Location: Sarasota
Posted on: 03/22/2019

Registered Nurse - RN - Surgical Services - OR - FT Evenings
Description: Description SHIFT: Evenings rotating weekends SCHEDULE: Full-time Are you looking for a rewarding career as a Registered Nurse Become part of an awarding team of Registered Nurse's here in the Surgical (more...)
Company: Doctors Hospital of Sarasota HCA Healthcare
Location: Sarasota
Posted on: 03/22/2019


Hiring-Health Benefit Reps
Description: Currently hiring motivated, self driven, goal oriented individuals who are looking to work at home. We are the largest discount Benefits
Company: AmeriPlan
Location: Sarasota
Posted on: 03/22/2019

Pain Physicians Sarasota Florida
Description: We have an immediate need for a full time Interventional Physiatrist/Pain Management Physician for Sarasota Florida Board
Company: HRC
Location: Sarasota
Posted on: 03/22/2019

Adult Nurse Practitioner Opportunity in St. Pete FL
Description: We have an Immediate need for Florida licensed Adult Nurse Practitioner for coverage
Company: Medical On Demand
Location: Pinellas Park
Posted on: 03/22/2019

Certified Nursing Assistant CNA
Description: As a Coastal Care associate, you will have the opportunity to collaborate with our Client Services colleagues to determine the work environments and schedules
Company: Coastal Care Nursing
Location: Port Charlotte
Posted on: 03/22/2019

Certified Nurse Assistants & Home Health Aides - Flexible PRN Home Car
Description: Do you love helping people Come make a daily difference in someone's life Immediate Interviews Monday-Friday from 10am-4pm Heart, Body Mind Home Care values our Caregivers At Heart, Body, Mind (more...)
Company: Heart Body & Mind Home Care
Location: Port Charlotte
Posted on: 03/22/2019

RN Full-Time, 7a-3:30p
Description: Full-Time RN 7AM-3PM br br Our nursing staff is our most valued asset. Providing our patients a home away from home. Caring for their every need, protecting their health. Making them feel safe, warm, (more...)
Company: Village Place Health and Rehabilitation Center
Location: Port Charlotte
Posted on: 03/22/2019

Clinical Coding
Description: We are a fast-growing tech company that provides a SaaS-based healthcare analytics platform for medical records analysis and targeted solutions for HEDIS Hybrid, Medicare and Exchange Risk Adjustment (more...)
Company: Mommy Jobs Online
Location: Sarasota
Posted on: 03/22/2019

Log In or Create An Account

Get the latest Florida jobs by following @recnetFL on Twitter!

Pinellas Park RSS job feeds