Pediatric Care Manager I (RN)

Company: Sunshine State Health Plan
Location: BRADENTON
Posted on: May 3, 2021

Job Description:

Position Purpose:Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care

• Develop, assess and adjust, as necessary, the care plan and promote desired outcome
• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems

Education/Experience:

Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.


Licenses/Certifications: Current states RN license.


For Sunshine Health (FL) Only: Employees supporting Florida's Childrens Medical Services (CMS) must have a minimum of two years of pediatric experience.

Keywords: Sunshine State Health Plan, Bradenton , Pediatric Care Manager I (RN), Other , BRADENTON, Florida