Nurse Case Manager

Job Description

Job Description

Do you want to make a difference in the community?

Are you looking to further your career in healthcare?

Do you want to be part of a growing organization?

Evara Health has been serving the community for 40 years. We are a not-for-profit health care organization with 14+ locations throughout Pinellas County, FL!

Join us at Evara Health as a dynamic Nurse Case Manager! Collaborate closely with providers, behavioral health therapists, and community stakeholders to empower patients and families towards healthier lifestyles.

You'll assess patient needs, enhance care systems, and champion patient education on behavioral and medical conditions. Your role is pivotal in optimizing service utilization and ensuring timely, quality care delivery.

As a core member of our care team, you'll help patients achieve their goals while aligning with Evara Health's mission of patient-centered excellence.

Ready to make a difference? Join us and be part of a transformative journey in healthcare!

ESSENTIAL DUTIES & RESPONSIBILITIES :

• Accepts warm hand offs of patients from medical and behavioral health providers to facilitate integration of care
• Provides case management services, including referrals to specialists, community resources, liaison with medical and behavioral health providers
• Coordinates care closely with patients and their families along with other team members to identify, develop and monitor patient self-care goals and to assure that medical and behavioral health needs are met
• Identifies high risk patients using 4 quadrant model for risk stratification (Q1, Q2, Q3, Q4)
• Tracks patients’ progress on self-care goals and alerts providers to need for enhanced services
• Responsible for tracking, monitoring, and completing assigned tasks in a timely manner as outlined in Evara Health policies.
• Responsible for appropriately assigning tasks to other care team members for action and follow-up
• Performs related duties necessary to ensure quality patient care for all assigned patients / tasks, including addressing Social Determinants of Health and other barriers with the collaboration of other team members.
• Provide in-person or virtual, individual and group health education and training, using standards of care, evidenced based programs / curriculums to patients and their families
• Identifies service gaps for patients and their families, develop individualized care plans with patients and their families and provide ongoing monitoring and support
• Ensure care coordination with patient’s provider, therapist, nurse, and other care team members
• Responsible for engaging patients (adults, children, and their families) in their care.
• Responsible for educating patients on other services available at Evara Health and where appropriate offering and scheduling those appointments.
• Assess and review appropriateness of the utilization of services by patients and their families in collaboration with Data Analyst and other team members
• System oversight of continuity of and quality of care
• Identifies system gaps in the continuum of care for patients and their families
• Actively participate in assigned Evara Health and community meetings and committees
• Prepares and present patient case reviews as requested
• Acts as a resource for Evara Health employees and community partners
• Responsible for providing top-notch customer service in line with Evara Health policies and procedures, standards, and expectations.
• Responsible for accurate documentation within patient records as outlined in workflow.
• Actively participate in Workflow Redesign and any assigned committees.
• Openly, clearly, and respectfully share and receive information, opinions and concerns and feedback in a supportive manner.
• Works collaboratively by actively participating in huddles, team meetings, by mentoring new and existing co-workers, building bridges, and creating rapport with team members across the organization.
• Effective and timely handling of other duties as assigned.
• Maintains strict confidentiality as appropriate.
• Strict adherence to all Evara Health, HIPAA, HRSA, State, Federal and accreditation agency rules, and regulations.

These essential job functions are not to be construed as a complete statement of all duties assigned. Employees will be required to perform other job-related duties as required.

MINIMUM QUALIFICATIONS :

• Critical thinking
• Ability to delegate and assign
• Ability to navigate and enter data into an electronic health record
• Preceptor
• Quality Monitoring
• Interpersonal Skills
• Effective written and oral communication skills

EDUCATION AND EXPERIENCE :

• Graduate of an accredited RN Program
• Required : Minimum two (2) years as an RN in a healthcare setting with some supervisory experience
• Preferred : Minimum two (2) years working with pediatric population

LICENSES, CERTIFICATION OR REGISTRATION :

• Valid and active RN license in the state of Florida
• Preferred : Certified Case Manager

BENEFITS :

• Up to 18 days of PTO in your first year
• Birthday Paid Day Off
• Pre-Taxed flexible insurance package
• 403B with company contributions
• Tuition reimbursement
• Paid Training

Apply now and be part of our passionate team dedicated to patient-centered excellence at Evara Health. Your journey to making a difference starts here!