Case Manager (Physical/Occupational Therapy)

<div class="content-intro"><p class="x_MsoNormal"><strong data-olk-copy-source="MessageBody">WHO WE ARE</strong></p> <p class="x_MsoNormal">NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.</p> <p class="x_MsoNormal">NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.&nbsp;</p></div><div><strong>JOB SUMMARY</strong>&nbsp;</div> <div>The role of the Care Manager is to promote&nbsp;quality,&nbsp;cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure member’s&nbsp;receive&nbsp;services and resources required to meet desired health and social outcomes. The Care Manager&nbsp;is responsible for&nbsp;providing patient centered care across the care continuum.&nbsp;</div> <div>&nbsp;</div> <div><strong>DUTIES &amp;&nbsp;RESPONSIBILITIES</strong>&nbsp;</div> <div>The&nbsp;following&nbsp;job description is intended to point out major responsibilities within the role, but it is not limited to these items.&nbsp;</div> <ul> <li> <div>Collect relevant clinical data to support the care planning process.&nbsp;</div> </li> <li> <div>Provide care plan support, intervention, and prioritization to transition members to&nbsp;optimal&nbsp;levels of health and self-management.&nbsp;</div> </li> <li> <div>Participate in interdisciplinary team meetings as&nbsp;required.&nbsp;</div> </li> <li> <div>Collaborate across providers and healthcare settings to ensure&nbsp;optimal&nbsp;quality outcomes for an assigned population.&nbsp;</div> </li> <li> <div>Provide transition of care interventions as&nbsp;required.&nbsp;</div> </li> <li> <div>Facilitate care coordination, self-management planning, discharge planning, and health education for an assigned population.&nbsp;</div> </li> <li> <div>Facilitate linkage to&nbsp;appropriate community&nbsp;resources to address social determinants of health.&nbsp;</div> </li> <li> <div>Adjudicate&nbsp;referrals and apply evidence-based clinical criteria to coordinate member care needs across all care settings.&nbsp;</div> </li> <li> <div>Ensure member communication and notices are composed in a manner consistent with regulatory standards.&nbsp;</div> </li> <li> <div>Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all&nbsp;additional&nbsp;duties as assigned.&nbsp;</div> </li> </ul> <div><strong>EDUCATION AND PROFESSIONAL EXPERIENCE</strong>&nbsp;</div> <ul> <li> <div>Diploma from a PT/PTA program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) or from an OT/COTA program accredited by the Accreditation Council for Occupational Therapy Education.</div> </li> <li> <div>Active Physical Therapist/Physical Therapist Assistant or Occupational Therapist/Occupational Therapist Assistant license in Florida.</div> </li> <li> <div>Minimum 2 years of experience in medical management clinical functions.&nbsp;</div> </li> <li> <div>Working knowledge of FIMS and NCQA standards&nbsp;</div> </li> </ul> <div><strong>PROFESSIONAL COMPETENCIES</strong>&nbsp;</div> <div>&nbsp;</div> <ul> <li> <div>High level&nbsp;of critical thinking and problem-solving skills&nbsp;</div> </li> <li> <div>Strong work ethic and overall positive attitude&nbsp;</div> </li> <li> <div>Effective communication skills including verbal and written.&nbsp;</div> </li> <li> <div>Ability to manage time effectively, understand directions, and work independently in a fast-paced environment.&nbsp;</div> </li> <li> <div>Demonstrated flexibility, organization, and self-motivation.&nbsp;</div> </li> <li> <div>Highly adaptable to change.&nbsp; &nbsp;&nbsp;</div> </li> </ul><div class="content-conclusion"><div style="text-align: left;">As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.</div></div>