Bachelor's degree in Nursing, Social Work, Healthcare Administration, or a related field.
At least 5 years of experience in clinical care coordination or case management.
Knowledge of community agencies and programs.
Current LVN or RN licensure in California is required.
Experience with Medi-Cal eligibility guidelines and related processes.
Strong problem-solving and customer service skills.
Responsibilities
Develop, implement, and monitor individualized care plans for patients with complex medical needs.
Coordinate communication among healthcare providers, patients, and families.
Conduct comprehensive assessments to identify patient needs and barriers to care.
Facilitate referrals to healthcare services and community resources.
Track patient progress and adjust care plans as necessary.
Ensure compliance with healthcare regulations and quality standards.
Provide education and support regarding treatment plans.
Benefits
Work within a mission-driven organization focused on enhancing the quality of life for vulnerable populations.
Opportunity to collaborate with a multidisciplinary healthcare team.
Emphasis on patient-centered care delivery aligned with best practices.
Support for professional development and continuing education.
Full Job Description
We are seeking a Clinical Care Manager to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Clinical Care Manager plays a pivotal role in coordinating and overseeing patient care to ensure optimal health outcomes. This position involves managing care plans, collaborating with multidisciplinary healthcare teams, and serving as a liaison between patients, families, and providers. The Clinical Care Manager is responsible for assessing patient needs, facilitating access to appropriate services, and monitoring progress to adjust care strategies as necessary. By integrating clinical expertise with strong organizational skills, this role aims to enhance patient satisfaction and improve overall care quality. Ultimately, the Clinical Care Manager ensures that care delivery is efficient, patient-centered, and aligned with best practices and regulatory standards.
Minimum Qualifications:
Bachelor's degree in Nursing, Social Work, Healthcare Administration, or a related field.
Requires at least 5 years of experience in clinical care coordination or case management.
Requires knowledge of and experience working with community agencies and programs.
Current and valid professional LVN or RN licensure in the State of CA.
Requires experience with Medi-Cal eligibility guidelines, application, and renewal/redetermination process.
Requires strong problem-solving and customer service skills.
Must be a CA Resident and must reside in CA while employed.
Current and valid California (CA) Driver's License.
Must use personal vehicle and current vehicle registration required.
Proof of auto insurance required, must maintain CA minimum insurance coverage.
BCLS CPR Certification required.
Relevant experience may substitute educational requirement on a year-for-year basis.
Preferred Qualifications:
Master's degree in Nursing, Public Health, Healthcare Administration, or related discipline.
Certification in Case Management (CCM) or Care Coordination.
Experience working with diverse patient populations and complex chronic conditions.
Familiarity with quality improvement methodologies and healthcare regulatory requirements.
Strong background in patient education and motivational interviewing techniques.
Responsibilities:
Develop, implement, and monitor individualized care plans for patients with complex medical needs.
Coordinate communication among healthcare providers, patients, and families to ensure continuity of care.
Conduct comprehensive assessments to identify patient needs, risks, and barriers to care.
Facilitate referrals to appropriate healthcare services and community resources.
Track patient progress and outcomes, adjusting care plans as necessary to meet evolving needs.
Ensure compliance with healthcare regulations, policies, and quality standards.
Provide education and support to patients and families regarding treatment plans and health management.
Collaborate with insurance providers and case management teams to optimize resource utilization
About Independent Living Systems
Independent Living Systems is a healthcare services company that provides managed care services to Medicare and Medicaid beneficiaries. The company offers a range of services, including care coordination, disease management, and transportation services. Independent Living Systems serves a variety of populations, including seniors, individuals with disabilities, and those with chronic conditions. The company was founded in 2001 and is headquartered in Lauderdale Lakes, Florida.
