care management specialist

Novant Health

<div>What We Offer:
<div>
Work Schedule: FT Monday - Friday, 8 am - 5 pm, no weekends or holidays. (On-Site)<br>
Location: 1423 Greenfield St. Wilmington, North Carolina 28401</div><div>
Department: MJ Clinic Greenfield</div><div></div><div><br>
The medication management specialist serves as a part of the healthcare team at Novant Health and collaborates with other team members, to provide optimal care. The medication management specialist accepts responsibility, authority, and accountability for management and provision of care in accordance with the current policies and procedures. Key component of job includes being responsible for exercising judgment and professional etiquette when interacting with clients/customers. Further responsibilities include assessing and collecting data from customers to resolve prescription status issues. This position is attractive to individuals who enjoy providing quality customer service, are detail-oriented, works well in a team and results driven environment and will convey professionalism, assurance/confidence with every interaction.</div>
What We're Looking For:
<ul><li><b>Education: </b>High School Diploma or GED, required.</li><li><b>
Experience: </b>Minimum of five years experience in pharmacy, required.</li><li><b>
Licensure/Certification: </b>PTCB Certification and NCBOP License, required.</li><li><b>
Additional Skills (required): </b>Considerable knowledge of medication names (both trade and generic) and their doses, routes of administration and adverse effects. Demonstrates patient interview skills and strong written and verbal communication skills with other healthcare professionals. Ability to follow verbal and written instructions. Basic technology skills. Other duties asoutlined in Novant Health and facility specific policies and procedures. Ability to drive/travel to multiple facilities/locations as needed.</li></ul></div>

Medication Management Specialist

Community Clinic

<div><p><i>Community Clinic is a trusted regional healthcare system dedicated to delivering exceptional, whole-person care in a compassionate, professional, and welcoming environment. As we continue to grow across the region, we remain grounded in one belief: people matter. That includes our patients&mdash;and our team. Every employee plays a vital role in living out our promise: </i><b><i>We care. You belong.<br>
</i></b></p><p></p><br>
<p><b>Job Summary
</b></p><p>Community Clinic is seeking a Value Based Care Specialist for our Primary &amp; Urgent Care location in Gentry, AR. The Value-Based Care (VBC) Specialist plays a critical role in supporting the organization&rsquo;s success under quality and value-based care models. This position is responsible for executing key functions across care coordination, quality metric performance, and reimbursable care management program support. Working within a Federally Qualified Health Center (FQHC) setting, the VBC Specialist proactively engages patients to close care gaps, coordinates transitions of care, supports enrollment and documentation for programs such as Advanced Primary Care Management (APCM), Chronic Care Management (CCM), and Remote Patient Monitoring (RPM), and monitors quality metrics to drive improved clinical outcomes and financial performance. An active Certified or Registered Medical Assistant certification is required. The schedule for this position is Monday - Thursday 7:00 AM - 5:00 PM and Friday 7:00 AM - 12:00 PM.<br>
</p><p></p><br>
<p><b>Key Responsibilities
</b></p><ul><li>Track and coordinate follow-up care for patients discharged from hospitals and emergency departments using ADT (Admission-Discharge-Transfer) feeds and payer notifications
</li><li>Contact patients post-discharge to assess needs, reinforce discharge instructions, and schedule follow-up appointments with the Primary Care Provider (PCP) and internal services
</li><li>Ensure timely documentation of all transitional care activities and patient outreach in the electronic health record (EHR)
</li><li>Serve as a liaison between patients, internal care teams (PCPs, behavioral health, dental, pharmacy, care managers), and external providers (specialists, imaging centers, tertiary facilities)
</li><li>Monitor and report on value-based care quality metrics, including HEDIS, UDS, and payer-specific measures
</li><li>Use population health tools, registries, dashboards, and payer program portals to identify patients with care gaps, open orders, or overdue preventive screenings
</li><li>Participate in multidisciplinary team meetings, quality improvement committees, and external quality metric meetings
</li><li>Support administration for APCM, CCM, and RPM programs in accordance with requirements
</li><li>Document care coordination activities, patient communications, and service delivery to support accurate billing and compliance with CMS standards
</li><li>Conduct patient outreach to schedule follow-up, preventive care, and annual wellness visits
</li><li>Educate patients on health center services and assist with internal referrals
</li><li>Ensure compliance with HIPAA/HITECH, CMS, HRSA, and other applicable requirements
</li><li>Follow standardized care management workflows, protocols, and documentation practices
</li><li>Create and update training materials for staff education on quality metric performance and program requirements
</li><li>Identify process improvement opportunities and participate in quality improvement initiatives
</li>Attend development activities to remain current on program requirements and best practices<br>
<li>
</li></ul><p></p><br>
<p><b>Skills
</b></p><ul><li>Strong communication, interpersonal, and customer service skills
</li><li>Attention to detail, especially data entry accuracy
</li><li>Strong organizational skills and ability to manage multiple priorities
</li><li>Knowledge of care coordination principles, transitions of care, and referral management
</li><li>Knowledge of value-based care concepts, including quality metrics (HEDIS, UDS, Star Ratings) and population health management
</li><li>Proficiency with electronic health records (EHRs), population health dashboards, payer program portals, and Microsoft Office Suite (especially Excel and PowerPoint).
</li>Ability to create training materials and educate staff on workflows and quality performance<br>
<li>
</li></ul><p></p><br>
<p><b>Required Qualifications
</b></p><ul><li>High School Diploma or GED
</li><li>Active Registered/Certified Medical Assistant (RMA or CMA)
</li><li>Proficient in use of electronic health records and Microsoft Office Suite
</li>Ability to work independently and as part of a multidisciplinary team<br>
<li>
</li></ul><p></p><br>
<p><b>Preferred Qualifications
</b></p><ul><li>Bilingual in English and Spanish or Marshallese
</li><li>2+ years of experience in care coordination, quality improvement, or healthcare.
</li><li>Experience working in an FQHC, CHC, or similar safety-net healthcare setting
</li><li>Familiarity with value-based care programs, CMS care management programs (APCM, CCM, RPM), and health risk stratification tools
</li>Experience with data reporting, quality metric tracking, or population health platforms<br>
<li>
</li></ul><p></p><br>
<p><b>Why Work at Community Clinic?
</b></p><ul><li>Be a part of a mission-driven organization committed to providing access to health-care to everyone in your community!
</li><li>Excellent Benefits Package including:
<ul><li>Health, Vision, Dental and Life Insurance
</li><li>403(b) Retirement plan (automatic employer contribution of 5% per paycheck!)
</li><li>Paid Time Off and Holidays
</li>Employee Discounts for Care<br>
<li>
</li></ul></li></ul><p></p><br>
<br>
Monday - Thursday 7:00 AM - 5:00 PM and Friday 7:00 AM - 12:00 PM.
<br>
40 - Hours</div>

Value Based Care Specialist

Atrium Health

<p></p><div><p><b>Department:</b></p>
13385 Enterprise Corporate - Managed Health Payor Contracting<p></p><p><b><br>
Status:</b>
</p>Full time<p></p><p><b><br>
Benefits Eligible:</b></p>
Yes<p></p><p><b><br>
Hou</b><b>rs Per Week:</b></p>
40<p></p><p><b><br>
Schedule Details/Additional Information:</b></p><ul><li><p>
First shift with some flexibility (8-5, 7-4, 9-6)</p></li><li><p>
Fully Remote Role from these states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY. Due to complex requirements, remote work is NOT permitted for short or long periods in: CA, CO, CT, HI, MA, MD, MN, NJ, NY, OR, RI, VT, WA and working Internationally (this includes working while on vacation).</p></li><li><p>
No relocation, No Sponsorship or transfer of visa for this position now or in the future.</p></li></ul><p></p><p><b>
Pay Range</b></p>
$28.55 - $42.85<p></p><p>
You will manage the administration of the contract portfolio and the day-to-day relationships between the System and Managed Care Organizations (MCOs) within that portfolio. Coordinates the financial, legal, operation and other administrative processes between the Systems and MCOs that are necessary to secure new contracts and maintain the viability of existing contracts. Supports designated leaders as assigned.</p><p></p><p><b>
Essential Functions</b></p><p></p><ul><li><p>
Manages administration of the assigned portion of the contract portfolio.</p></li><li><p>
Maintains current detailed working knowledge of all assigned payor contracts, and manages all activities related to managed care contract administration and compliance including, but not limited to: Chargemaster Increases, Contract Rate Adjustments, Contract Critical Events, Entity and Contract Database, and MHR document distributions.</p></li><li><p>
Creates and maintains electronic document database as well as original permanent files of all contract documents for all MCO contracts for the System.</p></li><li><p>
Communicates and educates operational implementation of new contract terms that affect revenue cycle functions.</p></li><li><p>
Manages the implementation process for all new or renegotiated managed care agreements.</p></li><li><p>
Manages the secure distribution of confidential contract documents and communicates contract changes to executives, revenue cycle personnel and others within the System.</p></li><li><p>
Monitors, reports, resolves and prevents operational issues related to existing managed care contracts. Routinely interacts with revenue cycle staff and MCO provider relations to resolve any trended or escalated operational issues that arise during the term of the contract.</p></li><li><p>
Serves as advisor and point of contact for all revenue cycle personnel for trended managed care operational and administrative issues. Supports the designated teammates and Managed Health Resources (MHR) Provider Services in their operational roles.</p></li><li><p>
Initiates and facilitates Joint Operating Committee (JOC) meetings with MCOs and facilitates internal meetings with revenue cycle staff for issue resolution and contract performance improvement. Coordinates all JOC and operational meetings, creates and distributes the agenda, creates performance reports and meeting minutes.</p></li><li><p>
Reviews assigned payor websites and external information, staying current with regard to changes to payor policies and other initiatives.</p></li><li><p>
Prepares clear, concise and focused internal communication/correspondence.</p></li><li><p>
Determines where to gather data based on requests; performs analyses and methodology application, under supervision, noting sources and methods.</p></li></ul><p></p><p><b>
Education, Experience and Certifications:</b></p><ul><li><p>
Associate's degree or equivalent experience required.</p></li><li><p>
Minimum two years' experience in managed care contracting, operations, or patient financial services for large healthcare provider or managed care organization</p></li><li><p>
Proficiency with MS Office</p></li><li><p>
Strong verbal and written communication skills</p></li></ul><p></p><p><b>
Preferred experience:</b></p><ul><li><p>
Managed care or insurance experience</p></li></ul><p></p><p><b>
Physical Requirements</b></p><p></p><ul><li><p>
Performs most work under normal office conditions; may include sitting for long periods of time, standing, walking, using repetitive wrist/arm motion or lifting articles up to twenty-five pounds.</p></li></ul><p></p><p>
#LinkedIn-Remote</p><p></p><p><b>
Our Commitment to You:</b></p><p></p><p>
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more &ndash; so you can live fully at and away from work, including:</p><p></p><p><b>
Compensation</b></p><ul><li>
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training</li><li>
Premium pay such as shift, on call, and more based on a teammate's job</li><li>
Incentive pay for select positions</li><li>
Opportunity for annual increases based on performance</li></ul><p></p><p><b>
Benefits and more</b></p><ul><li>
Paid Time Off programs</li><li>
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability</li><li>
Flexible Spending Accounts for eligible health care and dependent care expenses</li><li>
Family benefits such as adoption assistance and paid parental leave</li><li>
Defined contribution retirement plans with employer match and other financial wellness programs</li><li>
Educational Assistance Program</li></ul><p></p><p><b><br>
About Advocate Health</b></p><p></p><p>
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation&rsquo;s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.</p><p>
</p>Managed Care Specialist AHF</div>

Managed Care Specialist

Cosan Group

<div><b>Care Coordinator (Remote - US)</b><br>
<br>
<b>**This is a remote position, it is not mobile. Candidates must have a private, stationary, and HIPAA-compliant workspace within their home that is dedicated solely to work. Candidates must reside in the United States to be considered.**</b><br>
<br>
<b>Job Title: </b>Care Coordinator<br>
<b>Compensation: </b>$16.33 per hour - $19.00 per hour. (based on experience)<br>
<b>Location: </b>Remote (Arizona)<br>
<b>Work Environment: </b>Remote with HIPAA-compliant home office setup<br>
<br>
<b>Why Choose Us?</b><br>
Cos&aacute;n is a leading healthcare services organization committed to delivering exceptional patient care and innovative solutions to providers and partners. Join a mission-driven, collaborative team that values compassionate care and meaningful patient outcomes. As a Care Coordinator, you&rsquo;ll play a vital role in closing gaps in patient care and making a real difference in the lives of those managing chronic conditions.<br>
<br>
<b>What We&rsquo;re Looking For:</b><br>
We&rsquo;re looking for a compassionate, patient-centered Care Coordinator to manage a panel of patients and provide health coaching through monthly outreach. The ideal candidate is an excellent communicator who can build rapport with patients, collaborate with clinical teams, and advocate for patient needs. You thrive in fast-paced environments, are comfortable navigating multiple technology platforms, and are passionate about helping patients achieve better health outcomes.<br>
<br>
<b>What You&rsquo;ll Do:</b><br>
<b>Patient Outreach &amp; Health Coaching
</b><ul><li>Manage an assigned panel of 400-450 patients and conduct required monthly outreach to ensure continuity of care.
 </li><li>Conduct 50-60 daily outbound calls to patients, providing care plan support and health coaching aligned to their specific needs.
</li><li>Maintain call quality standards through consistent engagement and professional communication in every patient interaction.</li></ul><b>
Care Coordination &amp; Collaboration
 </b><ul><li>Collaborate with clinical teams, providers, and caregivers to identify and address clinical and social needs.</li><li>
Support care coordination goals by staying on schedule with monthly outreach targets.
 </li><li>Close gaps in patient care through Chronic Care Management, Behavioral Health Integration, and Remote Physiological Monitoring services.</li></ul><b>
Patient Advocacy
 </b><ul><li>Advocate for patient needs by actively listening to concerns, investigating issues, and communicating solutions to the patient&rsquo;s care circle.
</li><li>Partner closely with providers, clinical teams, and caregivers to support positive patient outcomes.</li></ul><b>
Documentation &amp; Compliance
</b><ul><li>Document all patient interactions in real time using the care coordination platform.
</li><li>Maintain HIPAA compliance in all patient communications and documentation.
</li><li>Maintain accurate, real-time documentation to support care coordination goals.</li></ul><br>
<br>
<b>Required Qualifications:</b><ul><li>
Must hold a nationally recognized medical assistant certification (CMA, RMA, CCMA, NCMA, CMAC, or equivalent state-issued MA-C).</li><li>
OR Certified Pharmacy Technician (CPhT)</li><li>
Minimum 2 years of clinical experience in a primary care, hospital, or specialty healthcare setting.</li><li>
Experience with Electronic Medical Records (EMRs) and strong computer navigation skills.</li><li>
Proficiency in multiple technology platforms and ability to navigate complex systems.</li><li>
HIPAA-compliant home office setup with minimum 50 Mbps download / 5 Mbps upload internet capability.</li><li>
Must be legally authorized to work in the United States.</li></ul><br>
<br>
<b>Preferred Qualifications:</b><ul><li>
Experience in care coordination, chronic care management, or behavioral health integration.</li><li>
Familiarity with remote patient monitoring (RPM) or remote physiological monitoring platforms.</li><li>
Previous experience managing large patient panels (200+).</li><li>
Bilingual capability (English and Spanish preferred).</li></ul><br>
<br>
<b>Compensation &amp; Benefits:</b><ul><li>
Paid Time Off + Company Holidays.</li><li>
Medical, Dental, Vision Insurance.</li><li>
Complimentary Life Insurance.</li><li>
401(k) Plan.</li><li>
Optional Short-Term, Long-Term Disability, Critical Illness &amp; Accident coverage.</li><li>
Employee Assistance Program including mental health resources.</li><li>
Company-provided equipment (laptop, monitor, headset, etc.).</li></ul><br>
<br>
 <b>Work Environment &amp; Requirements:</b><ul><li>
100% Remote with a Monday&ndash;Friday schedule&mdash;no weekends or late nights.</li><li>
High-speed broadband internet and private home workspace required<ul><li>
Candidates must complete a company-provided internet speed test to confirm a minimum of 50 Mbps download / 5 Mbps upload.</li></ul></li><li>
Private workspace for compliance with HIPAA privacy laws.</li></ul>
<br>
If you&rsquo;re a compassionate healthcare professional ready to make a meaningful impact in patients&rsquo; lives, we want to hear from you. Apply today and help us deliver exceptional care coordination!<br>
<br>
<i>Cos&aacute;n Group is an Equal Opportunity Employer and values diversity at all levels of the organization. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other characteristic protected by law.</i><br>
<p>
</p><p>NseePQYnf9</p></div>

Care Coordinator (Arizona)

Equality Health

<div><p><b>Position Title: Care </b><b>Coordinator</b></p><p><b>
Reports To:</b> <b>Supervisor, Clinical Outreach</b></p><p><b>
Classification: Non-Exempt (Full-time)</b></p><p><b>
Places of Work: Remote (Preferred location: AZ)</b></p><p><b>
Schedule &amp; Work Expectations:</b></p><ul><li>
This is a remote, non-exempt position.</li><li>
Care Coordinator are assigned to a primary market and are expected to work within that market&rsquo;s hours of operation (typically 8:00 AM &ndash; 6:00 PM local time).</li><li>
Candidates must be willing to work the time zone aligned with their assigned market, regardless of physical residence.</li><li>
While each Care Coordinator is assigned a primary market, work priorities may shift based on business needs, and team members may support additional markets when required.</li><li>
Flexibility with schedule adjustments may be requested periodically to support engagement initiatives or priority campaigns.</li></ul><p><b>
About the Role:</b></p><p>
The Care <b>Coordinator</b> is primarily responsible for providing supportive care and assistance to a diverse patient population to identify barriers to self-care and healing, decision making, and communication in navigating the healthcare system. This individual works closely with, Community Health Workers, Chaplains, and other members of the Clinical Operations team, and consistently demonstrates a high standard of ethical behavior, professionalism, sensitivity, and confidentiality.</p><p><b>
Key Responsibilities:</b></p><div><ul><li>
Conduct outbound phone calls to members to conduct health assessments, identify care needs, and determine appropriateness for participation in care coordination programs</li><li>
Assist and support patients with barriers to care including, but not limited to, scheduling appointments, and locating and accessing community resources</li><li>
Work collaboratively with patients, network providers, referral coordinators, office and hospital staff; document all activities</li><li>
Communicate care coordination services available to patients and caregivers</li><li>
Screen for physical health and behavioral health needs to refer to appropriate healthcare professionals for effective and timely intervention</li><li>
Perform a variety of activities to provide meaningful data to providers, patients and their families</li><li>
Participate in a variety of educational programs to maintain current skill and competency levels</li><li>
Perform miscellaneous job-related duties as assigned</li></ul></div><p><b>
Required Skills &amp; Qualifications:</b></p><div><ul><li>
Associate&rsquo;s degree in Healthcare or a related field of study; or, an equivalent combination of education and/or experience</li><li>
Minimum two (2) years of experience in a directly related position in the healthcare industry</li><li>
Proficiency with Microsoft Office applications and web-based technologies</li><li>
Strong outbound calling experience</li><li>
Ability to work independently in a productivity-based environment</li><li>
Tech-savvy: able to navigate multiple systems simultaneously</li><li>
Comfortable learning proprietary platforms</li><li>
Basic Excel proficiency (pivot tables, formulas, project-based spreadsheets)</li><li>
Reliable high-speed internet meeting company specs</li><li>
Flexible schedule within assigned market hours</li><li>
Ability to pivot between priorities quickly</li></ul></div><p><b>
 </b><b>Preferred Skills &amp; Qualifications:</b></p><div><ul><li>
Previous experience, knowledge and understanding of coordinating care for members</li><li>
Familiarity with federal and state laws and requirements related to healthcare and health information protection</li><li>
One or more of the following certifications: Basic Life Support (BLS), Certified Medical Assistant (CMA), Certified Nursing Assistant (CNA), Emergency Medical Technician (EMT)</li><li>
Excellent verbal, written and interpersonal communication skills</li><li>
Demonstrated ability to gain acceptance and compliance from clinical staff to achieve mutually beneficial outcomes</li><li>
Excellent problem-solving skills, including the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action</li><li>
Strong organizational and prioritization skills; able to manage multiple activities and work independently with minimal supervision</li><li>
Bilingual (strongly preferred)</li><li>
Experience in customer service environments (call center acceptable if adaptable)</li></ul></div><p></p><p><b><br>
About the Organization:</b></p><p>
Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.</p><p>
Through its supplemental care management services and proprietary technology platform, CareEmpower&trade;, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.</p><p>
In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities.</p><p><i>
Equality Health </i><i>provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.</i></p><p><i>
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.</i></p></div>

Care Coordinator (Bilingual)

AdventHealth Lake Wales

<div><p><b>Our promise to you:</b></p><p></p><p>
Joining AdventHealth is about being part of something bigger. It&rsquo;s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that <b>together</b> we are even better.</p><p></p><p><b>
All the benefits and perks you need for you and your family:</b></p><p></p><ul><li><p>
Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance</p></li><li><p>
Paid Time Off from Day One</p></li><li><p>
403-B Retirement Plan</p></li><li><p>
4 Weeks 100% Paid Parental Leave</p></li><li><p>
Career Development</p></li><li><p>
Whole Person Well-being Resources</p></li><li><p>
Mental Health Resources and Support</p></li><li><p>
Pet Benefits</p></li></ul><p></p><p><b>
Schedule:
</b></p>Full time<p></p><p><b>
Shift:</b></p>
Day (United States of America)<p></p><p><b>
Address:</b></p>
410 S 11TH ST<p></p><p><b>
City:</b></p>
LAKE WALES<p></p><p><b>
State:</b></p>
Florida<p></p><p><b>
Postal Code:</b></p>
33853<p></p><p><b>
Job Description:</b></p><p></p><p>
Up to $5K Sign on Bonus (if eligible)</p><p>
Up to $10K Relocation (if eligible)</p><p>
Provides grief counseling, disease adjustment support, crisis intervention, goals of care planning support, and de-escalation services for patients as appropriate.</p><ul><li>Assesses patients&rsquo; and families&rsquo; wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning.</li><li>Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan.</li><li>Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs.</li><li>Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate.</li></ul><p>
&bull; Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. &bull;Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services.</p><p>
&bull; Organizes and facilitates patient and family care conferences with the multidisciplinary team. &bull;Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. &bull;Provides patient and family advocacy, and support patient&rsquo;s choice and patient rights during hospitalization.</p><ul><li>Communicates with Payors patient&rsquo;s needs for authorization for post-acute care as needed.</li><li>Assesses readmitted patients for the patient&rsquo;s and family&rsquo;s perceived reasons for the readmission.</li><li>Other duties as assigned.</li></ul><div><b>
Knowledge, Skills, and Abilities:</b><br>
<ul><li>Excellent interpersonal communication and negotiation skills [Required</li><li>Critical thinking and problem-solving skills [Required]</li><li>Psychosocial assessment skills [Required]</li><li>Customer service skills [Required]</li></ul></div><ul><li>Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required]</li><li>Effective organizational skills [Required]</li><li>Computer proficiency with Outlook e-mail and electronic medical records [Required]</li><li>Flexible in a complex and changing healthcare environment [Required]</li><li>Understanding of pre-acute and post-acute venues of care and post-acute community resources [Required]</li><li>Maintains a current working knowledge of services available in the local community, particularly services available to patients with limited or non-existent payment resources [Required]</li><li>Strong interview, assessment, and organizational skills [Required]</li><li>Leadership skills [Required]</li><li>Data analysis skills [Required]</li><li>Current working knowledge of discharge planning, utilization management, care management, performance improvement and managed care reimbursement [Preferred]</li><li>Knowledge of state and federal guidelines pertinent to Care Management [Preferred]</li><li>Ability to identify appropriate community resources and to work collaboratively with patients, families, multidisciplinary team and community agencies to achieve desired patient outcomes [Preferred]</li><li>Knowledge of state and federal guidelines pertinent to care management [Preferred]</li></ul><div><b><br>
Education:</b><br>
<ul><li>Master's [Required]</li></ul><br>
<b>
Field of Study:</b><br>
<ul><li>N/A</li></ul><br>
<b>
Work Experience:</b><br>
<ul><li>2+ care management experience [Preferred]</li><li>2+ social work [Required]</li></ul><br>
<b>
Additional Information:</b><br>
Additional Licensure or certification requirements may apply depending on the specific unit or state in which this position is located. Please consult the relevant credential grid for detailed information regarding these requirements<br>
<br>
<b>Licenses and Certifications:</b><br>
<ul><li>Accredited Case Manager (ACM) [Preferred]</li><li>Certified Case Manager (CCM) [Preferred]</li></ul><br>
<b>
Physical Requirements:</b> <i>(Please click the link below to view work requirements)</i><br>
Physical Requirements - https://tinyurl.com/msy4mja2</div><p></p><p><b>
Pay Range:</b></p><p></p>
$22.88 - $42.54<p></p><p><i>
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.</i></p></div>

Care Management Social Worker Nonexempt

Trillium Health Resources

<div><div><b>Pay Plan Title: </b>Clinician</div><div><b>
Working Title: </b>Population Health Operations (PHO) Clinical Oversight Clinician</div><div><b>
FLSA Status: </b>Exempt</div><div><b>
Posting Salary Range: </b>$66,240- $88,595</div><div><b>
Office Location: </b>Remote within North Carolina.</div><div></div><div><b><br>
POSTING DETAILS:</b></div><div></div><div><b><br>
Make an Impact</b></div><div></div><div><br>
Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.</div><div></div><div><b><br>
Why Work for Us</b>?</div><div></div><div><br>
Trillium believes that empowering others begins with supporting our team. We offer our employees:</div><div></div><div><br>
<ul><li>
A collaborative, mission-driven work environment</li><li>
Competitive benefits and work-from-home options for most positions</li><li>
Opportunities for professional growth in a diverse inclusive culture</li></ul></div><div></div><div><br>
Every day, our work changes lives &ndash; from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.</div><div></div><div><br>
If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!</div><div></div><div><b><br>
What We&rsquo;re Looking For</b></div><div></div><div><br>
Trillium Health Resources has a career opening for a Population Health Operations (PHO) Clinical Oversight Clinician to join our team! The PHO Clinical Oversight Clinician is responsible for developing policies, procedures, practices, and systems that support the provision of care management services. This role is also responsible for demonstrating clinical expertise for specific complex and/or rising risk member populations and will work to identify members that are appropriate for population health programs utilizing data informatics, along with providing interventions and education to promote health prevention and promotion.</div><div></div><div><b><br>
On a typical day, you might:</b></div><div></div><div><br>
<ul><li>
Develop, review and evaluate operating policies, practices and procedures with department-wide impact and provide critical feedback on outcomes to enhance effectiveness.</li><li>
Manage, review, and analyze operations and services provided for adherence to program goals and objectives utilizing databases, dashboards, performance outcome data and reports. Recommend changes based on analyses.</li><li>
Collaborate with internal teams to identify gaps or opportunities for improved workflows or process changes for special populations.</li><li>
Serve as a subject matter expert regarding identified special populations, regulatory requirements, policies, procedures, programs and staff support; provide staff education and training on relevant program components.</li><li>
Oversee utilization of resources used by specialty population e.g. coordination of secure transportation requests for special populations.</li></ul></div><div></div><div><b><br>
Employee Benefits:</b></div><div></div><div><br>
Trillium knows that work/life balance is essential. That&rsquo;s why we offer:</div><div></div><div><br>
<ul><li>
Typical working hours: 8:30 am &ndash; 5:00 pm; flexible work schedules with some roles with management approval.</li><li>
Work-from-home options available for most positions</li><li>
Health Insurance with no premium for employee coverage</li><li>
Flexible Spending Accounts</li><li>
24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year</li><li>
NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook</li><li>
401k with 5% employer match and immediate vesting</li><li>
Public Service Loan Forgiveness (PSLF) qualifying employer</li><li>
Quarterly stipend for remote work supplies</li></ul></div><div></div><div><b><br>
Qualifications</b></div><div></div><div><br>
Required:</div><div><ul><li>
Master&rsquo;s degree in a health or human services field and one (1) year of experience providing care to complex individuals with Behavioral Health conditions.</li><li>
Fully licensed by the state of North Carolina as an LCSW, LCMHC, LPA, LMFT, LCAS or RN.</li><li>
Must have a valid driver&rsquo;s license.</li><li>
Must reside within North Carolina.</li><li>
Must be able to travel within catchment as required.</li></ul></div><div></div><div><br>
Preferred:</div><div><ul><li>
At least one (1) year of clinical policy review, conducting audits, or quality improvement review experience.</li></ul></div><div></div><div><b><br>
Deadline for Application:</b> Wednesday, April 29, 2026 at 11:59pm</div><div></div><div><b><br>
How to Apply</b></div><div></div><div><br>
To be considered, submit your application and resume through our ADP Career Center. Your resume must include:</div><div></div><div><br>
<ul><li>
Employer name, dates of service (month/year), average hours worked per week, and essential job duties</li><li>
Education details (degree type, date awarded, institution, field of study)</li><li>
Licensure/certification information, if applicable</li></ul></div><div></div><div><br>
After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You&rsquo;ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.</div><div></div><div><br>
Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.</div><div></div><div><b><br>
Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.</b></div><div></div><div><i><br>
#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth</i></div></div>

Population Health Operations (PHO) Clinical Oversight Clinician

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