Aids Healthcare Foundation

Aids Healthcare Foundation Fort Lauderdale, FL 33301, United States
Jan 05, 2018
Full time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are: • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right   STILL INTERESTED? Please continue!   Responsibilities: Summary The RN Care Team Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida. Key responsibilities include leading the care team which provides culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the RN Care Team Manager, participating in the gathering and transmission of information and data to the RN Care Team Manager for assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.    Essential Duties & Responsibilities Duties and Responsibilities include but are not limited to: • Collaborates with and plays a lead role with Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. • Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. • Responsible to manage and coordinate care for an assigned population of Level 3, high risk members. • Orients new members to the Managed Care program through Welcome and Transition calls. • Completes assessments and re-assessments timely for members assigned to the Care Team. • With the member, establishes patient centered long term and short term goals for care and self management. • With the input of the member, family and medical team, creates an appropriate and timely individual care plan to assist the member to achieve the established goals. • Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wrap around solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. • Works to deliver care management services in an efficient and cost effective manner. • Performs PAC assessments and exception request visits as requested  • Adheres to PAC Manual when delivering PAC assessment or reassessment services.  • Communicates the care plan to the Primary Care Physician, member and others in the Health Home. • Revises the Care Plan as needed and at a minimum following hospitalization of the member or following the annual re-assessment. • Meets with patients face to face in the home or at physician appointments to complete assessments and other contacts, as necessary. • With the support of the Care Team,  re-engages the member following hospital admissions and emergency room use through reassessment, coordination of transition of care, including PCP appointment and transportation as needed. • Monitors the appropriate use of outpatient ancillary services, medication adherence, compliance to PCP visit schedules and results of lab work. • Provides Transition of Care follow-up visits or calls to patients following change in level of care. • Provides health education regarding disease process, medications, medication adherence, community resources and benefits. • Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. • Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. •  Maintains at least the minimum performance and productivity standards. • Completes a minimum of three recommended AIDS related in-services, trainings or conferences per year. o Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency • Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. • Advocates for member needs with medical provider, RN Care Team Manager and community. • Reports all complaints and grievances per grievance policy. • Other duties as assigned to ensure team goals are met. Management Responsibilities Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Supervises and delegates appropriate tasks to the LPN Care Partner, the Care Coordinator and the Social Worker and monitors for the appropriate completion of assigned tasks. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management on member clinical, satisfaction, utilization and cost issues. Signs off on Care Plans developed by the LPN Care Partner.   Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN Program. BSN preferred.  At least five years clinical experience and three years Case Management, Community nursing, Home Health or Hospice nursing desired Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification within two years of employment. Certified in AIDS Care or eligible for ANAC certification within three years of employment Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.  Language Skills Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues   Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing. Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables.   Travel:  Over 50% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, and AHF office.  Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a leader or member  of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred  Certification in case management preferred  Current CPR (Cardio Pulmonary Resuscitation) Certificate Required Valid Florida Driver’s License with proof of automobile liability insurance
Aids Healthcare Foundation Fort Lauderdale, FL 33301, United States
Jan 05, 2018
Full time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are: • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right   STILL INTERESTED? Please continue!   Responsibilities: Essential Duties & Responsibilities Includes the following.  Other duties may be assigned . Maintains clinical competency, as demonstrated in providing and directing patient care. Assures that nursing staff practice within their individual scopes of practice. Assists and communicates with medical staff concerning patient care issues (e.g., change in condition, refill requests, patient incidents). Assesses and Triages patients. Participates in the case management of individual patients to ensure the continuity of care. Develops and oversees internal working systems relevant to the medical/nursing operations within a clinic setting. Produces required reports on a timely basis. Maintains compliance with DHS, County Public Health, and other regulatory agencies, statutes and standards. Directs nursing care in a manner reflective of the philosophy of AIDS Healthcare Foundation. Provides education to patient and patient's personal support system in areas such as disease management, safe sex, etc. Assumes supervisory duties such as performance evaluations, counseling and progressive discipline of the nursing staff. Complies with safety standards and infection control standards. Promotes team work, good interpersonal relations and communication among staff at the healthcare setting and corporate level. Participates in nursing staff orientation and serves as a clinical resource. Plans and participates in educational programs for the nursing staff. Oversees and controls supplies that directly impact patient care (e.g. ordering and charging stock medications, medical supplies and patient care equipment and/or supplies. Exercises appropriate judgment and good decision-making skills. Assumes additional responsibilities as necessary (i.e., assisting the nursing staff at times of critical need, attendance at all assigned committees). Participation in AHF Meetings/Committees Attends Nurse Managers Meeting. Attends Leadership Meeting. Attends HCC Staff Meeting. Attends other meetings as assigned. Supervisory Responsibilities Carries out supervisory responsibilities in accordance with AHF’s policies and applicable laws.  Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work, appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.    Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN program. BSN preferred. Computer/Software Skills & Abilities To perform this job successfully, an individual should have knowledge of word processing software.    Language Skills Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents.  Ability to respond to common inquiries or complaints from customers, regulatory agencies or members of the business community.  Ability to write speeches and articles for publication that conform to prescribed style and format.  Ability to effectively present information to top management, public groups, and/or boards of directors.   Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs.   Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.   Other Skills & Abilities/Qualifications Knowledge of HIV/AIDS and related medical and patient care issues and concerns in diverse populations. Previous administrative and supervisory experience preferred. Strong clinical nursing skills. Demonstrated proficiency in phlebotomy and intravenous insertion, care and therapy. Fluent in conversational Spanish and/or Creole preferred. Understanding of case management and benefits preferred. Ability to work at various healthcare centers.  Certificates, Licenses and Registrations Current State RN License in applicable working location. Current CPR certification (Healthcare Provider). Valid Driver License in state of employment, with proof of liability insurance.
Aids Healthcare Foundation Fort Lauderdale, FL , United States
Jan 05, 2018
Full time
The RN Care Team Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida.   Key responsibilities include leading the care team which provides culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the RN Care Team Manager, participating in the gathering and transmission of information and data to the RN Care Team Manager for assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.    Essential Duties & Responsibilities Duties and Responsibilities include but are not limited to: Collaborates with and plays a lead role with Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. Responsible to manage and coordinate care for an assigned population of Level 3, high risk members. Orients new members to the Managed Care program through Welcome and Transition calls. Completes assessments and re-assessments timely for members assigned to the Care Team. With the member, establishes patient centered long term and short term goals for care and self management. With the input of the member, family and medical team, creates an appropriate and timely individual care plan to assist the member to achieve the established goals. Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wrap around solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. Works to deliver care management services in an efficient and cost effective manner. Performs PAC assessments and exception request visits as requested  Adheres to PAC Manual when delivering PAC assessment or reassessment services. Communicates the care plan to the Primary Care Physician, member and others in the Health Home. Revises the Care Plan as needed and at a minimum following hospitalization of the member or following the annual re-assessment. Meets with patients face to face in the home or at physician appointments to complete assessments and other contacts, as necessary. With the support of the Care Team,  re-engages the member following hospital admissions and emergency room use through reassessment, coordination of transition of care, including PCP appointment and transportation as needed. Monitors the appropriate use of outpatient ancillary services, medication adherence, compliance to PCP visit schedules and results of lab work. Provides Transition of Care follow-up visits or calls to patients following change in level of care. Provides health education regarding disease process, medications, medication adherence, community resources and benefits. Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. Maintains at least the minimum performance and productivity standards. Completes a minimum of three recommended AIDS related in-services, trainings or conferences per year. Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. Advocates for member needs with medical provider, RN Care Team Manager and community. Reports all complaints and grievances per grievance policy. Other duties as assigned to ensure team goals are met. Management Responsibilities: Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Supervises and delegates appropriate tasks to the LPN Care Partner, the Care Coordinator and the Social Worker and monitors for the appropriate completion of assigned tasks. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management on member clinical, satisfaction, utilization and cost issues. Signs off on Care Plans developed by the LPN Care Partner.   Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN Program.  BSN preferred. At least five years clinical experience and three years Case Management, Community nursing, Home Health or Hospice nursing desired Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification within two years of employment. Certified in AIDS Care or eligible for ANAC certification within three years of employment.   Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.    Language Skills: Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues  Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing..  Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables.   Travel:  Over 50% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, and AHF office.  Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a leader or member  of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred Certification in case management preferred Current CPR (Cardio Pulmonary Resuscitation) Certificate Required Valid Florida Driver’s License with proof of automobile liability insurance
Aids Healthcare Foundation Fort Lauderdale, FL , United States
Jan 05, 2018
Full time
The Director of Utilization and Case Management is accountable for the Managed Care Division’s Florida based clinical program operations, including Managed Care Chronic Case Management, Utilization Management, Waiver programs and Ryan White Medical Case Management.     Responsibilities: Duties and Responsibilities include but are not limited to:   Collaborates with all managed care departments and AHF functions to develop and maintain Managed Care clinical programs, including the Chronic Care Model, which is the basis for the Case Management Program.. Works closely with management and staff to facilitate adherence to Plan operational standards and regulations. Responsible for Project Management related to clinical programs, including specific regulatory required processes and program enhancements. Assures timely reporting of required data through the Quality Management Committees and contracted private and/or governmental agencies and the Board of Directors,  including the annual UM Program Description, Workplan and annual UM Program Summary. Ensures there is appropriate monitoring of staff and department outcomes relative to performance objectives, including individual and collective feedback to the clinical team. Demonstrates comprehensive knowledge of Agency for Health Care Administration (AHCA), and Medicare (CMS) Medicare Advantage and Part D regulations as they pertain to managed care clinical operations. Collaborates with all managed care departments to ensure operational effectiveness of the Clinical Programs. Establishes measureable performance goals for staff and department programs including, UM, CM, MTMP, Ryan White and Waiver Medical Case Management Programs. Is an active participant in the preparation and execution of the Utilization Management Committee. Regularly attends and participates in the bi-weekly FL Operations meeting Reports UM/CM Department performance and outcomes to appropriate committees. Collaborates and cooperates with the Compliance Officer to ensure programmatic compliance to regulatory guidance in assigned areas. Assists with development of the operational budget and allocation of resources. Participates in Contracting and Provider Relations activities as necessary to develop and maintain provider networks based on member need. Ensures the appropriate authorization and appeals processes per regulatory requirements.  Collaborates with the Medical Director to ensure the Clinical appropriateness of programs and process.   Management Responsibilities Demonstrates the ability to organize and facilitate effective meetings. Develops project plans, coordinates projects and communicates project outcomes Responsible for hiring, training and motivating staff Mentors and develops the Manager of UM/CM, case managers, and others, as needed, on the team Disciplines in conjunction with Human Resources and AHF guidelines Addresses concerns and resolves issues   Participates in AHF Meetings/Committees Attends AHF and Managed Care Committees including: Quality Management Committee, Pharmacy and Therapeutics Utilization Management Committee Member Provider Committee Medical Staff Committee   Qualifications: To perform this job successfully, an individual must be able to satisfactorily perform the essential duties.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience •    Graduate from an accredited RN program  •    Current, unrestricted FL RN license •    BS in Nursing or other healthcare field •    Masters Degree preferred or demonstrated comparable managerial and executive experience •    Minimum of five years experience in managed care with emphasis in Medicaid and Medicare. Computer/Software Skills & Abilities To perform this job successfully, an individual should have knowledge of standard business software, including but not limited to: word processing, spreadsheet software, presentation software, experience with relational database principles and functions, and a basic understanding of claims administration principles is required. Language Skills Ability to read, analyze, and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or issues.  Ability to effectively present information to top management or public groups. Mathematical Skills High mathematical skills required. Ability to apply mathematical principles to practical solutions, using fractions, percentages, ratios, and proportions. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.   Travel:   Travel locally and in the domestic United States up to 40% of the time Other Skills & Abilities/Qualifications Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a part of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations. Certificates, Licenses and Registrations Current unrestricted FL RN License required CCM preferred
Aids Healthcare Foundation Jacksonville, FL , United States
Jan 05, 2018
Part time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are: • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right   STILL INTERESTED? Please continue! AHF is currently seeking a Part Time LPN in our Jacksonville clinic. The hours are Monday-Friday 8 am to 2 pm.   We offer a competitive salary and a great work environment.   Responsibilities: Essential Duties & Responsibilities Includes the following.  Other duties may be assigned.   Documents patient's weight, temperature, pulse, respiration and blood pressure at patient healthcare visit as ordered or per protocol. Collects other pertinent patient information as defined by Department of Medicine—eg:, Depression Screening ; Tuberculosis screening; presenting chief complaint Collects samples such as urine, blood, and stool specimens in the Healthcare Centers as ordered and instructs patients in home collection of urine, stool and sputum specimens, when appropriate. Performs phlebotomy as ordered and prepares specimens for transport to laboratory. Performs patient procedures as ordered including ear lavages; EKGs; dressing changes; injections and documents appropriate information in patient’s EMR. Documents services performed for compliance and reporting purposes. Reviews physician orders, lab requests or follow-up needs with patient. Collaborates with other nursing personnel and participates as a team member.  May receive laboratory results over the telephone and transmit them to the Nurse Manager and the patient's medical provider in a timely manner. Administers Purified Protein Derivative (PPD), as ordered.  Documents in patient’s EMR and completes associated County required documents and scans and sends to County. Administers controlled medication and documents appropriately in EMR. Reports changes in patient's physical status to the Nurse Manager or medical provider. Assists physician with examinations and procedures as assigned. Documents observations as requested by an MD, PA , NP and/or Nurse Manager in the patient's medical record. Receives and processes medication refill requests; verifies medication requests with healthcare provider and obtains appropriate documentation. Ensures maintenance of patient confidentiality. Maintains supplies and cleanliness of examination rooms. Maintains logs as directed by the Nurse Manager. Maintains standard precautions for infection control. Able to travel to other HealthCare Centers as needed for cross-covering staffing requirements.   Participation in AHF Meetings/Committees Attends AHF meetings as assigned.   Supervisory Responsibilities This job has no supervisory responsibilities.   Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience High school diploma or general education degree (GED);  graduate of an accredited licensed vocational nurse program.  Minimum of two years related experience and/or training.   Computer/Software Skills & Abilities Proficiency in word processing and basic data base programs. Proficiency in Logician/EMR (training and continuing education will be provided in house).   Language Skills Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.     Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs.     Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.   Other Skills & Abilities/Qualifications Communicates in a tactful and professional manner. Bilingual (English/Spanish) highly desirable. Experience and sensitivity in working with individuals affected by HIV/AIDS. Ability to work to travel to multiple healthcare centers for cross-covering staffing requirements preferred. Certificates, Licenses and Registrations Valid Florida LPN License, without restrictions. Valid C.P.R. certification. Certificate in phlebotomy and intravenous (IV) therapy; certification must be presented upon hire or prior to the completion of the initial 90-day introductory period. Current Driver’s license and proof of liability insurance.
Aids Healthcare Foundation Lithonia, GA , United States
Jan 05, 2018
Full time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are: • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right   STILL INTERESTED? Please continue!   Responsibilities: Essential Duties & Responsibilities Includes the following.  Other duties may be assigned . Maintains clinical competency, as demonstrated in providing and directing patient care. Assures that nursing staff practice within their individual scopes of practice. Assists and communicates with medical staff concerning patient care issues (e.g., change in condition, refill requests, patient incidents). Assesses and Triages patients. Participates in the case management of individual patients to ensure the continuity of care. Develops and oversees internal working systems relevant to the medical/nursing operations within a clinic setting. Produces required reports on a timely basis. Maintains compliance with DHS, County Public Health, and other regulatory agencies, statutes and standards. Directs nursing care in a manner reflective of the philosophy of AIDS Healthcare Foundation. Provides education to patient and patient's personal support system in areas such as disease management, safe sex, etc. Assumes supervisory duties such as performance evaluations, counseling and progressive discipline of the nursing staff. Complies with safety standards and infection control standards. Promotes team work, good interpersonal relations and communication among staff at the healthcare setting and corporate level. Participates in nursing staff orientation and serves as a clinical resource. Plans and participates in educational programs for the nursing staff. Oversees and controls supplies that directly impact patient care (e.g. ordering and charging stock medications, medical supplies and patient care equipment and/or supplies. Exercises appropriate judgment and good decision-making skills. Assumes additional responsibilities as necessary (i.e., assisting the nursing staff at times of critical need, attendance at all assigned committees). Participation in AHF Meetings/Committees Attends Nurse Managers Meeting. Attends Leadership Meeting. Attends HCC Staff Meeting. Attends other meetings as assigned. Supervisory Responsibilities Carries out supervisory responsibilities in accordance with AHF’s policies and applicable laws.  Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work, appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.    Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN program. BSN preferred. Computer/Software Skills & Abilities To perform this job successfully, an individual should have knowledge of word processing software.    Language Skills Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents.  Ability to respond to common inquiries or complaints from customers, regulatory agencies or members of the business community.  Ability to write speeches and articles for publication that conform to prescribed style and format.  Ability to effectively present information to top management, public groups, and/or boards of directors.   Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs.   Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.   Other Skills & Abilities/Qualifications Knowledge of HIV/AIDS and related medical and patient care issues and concerns in diverse populations. Previous administrative and supervisory experience preferred. Strong clinical nursing skills. Demonstrated proficiency in phlebotomy and intravenous insertion, care and therapy. Fluent in conversational Spanish preferred. Understanding of case management and benefits preferred. Ability to work at various healthcare centers.  Certificates, Licenses and Registrations Current State RN License in applicable working location. Current CPR certification (Healthcare Provider). Valid Driver License in state of employment, with proof of liability insurance.
Aids Healthcare Foundation Fort Lauderdale, FL , United States
Jan 05, 2018
Full time
Utilization Review is the process in which medical review determinations are made based on clinical guidelines and structured processes. This position reviews the utilization of the organization/plan’s resources against established criteria, monitors and evaluates the medical necessity, appropriateness and efficient use of health care services. The position also provides reports and recommendations for improved utilization of resources while maintaining quality of care to the UM/CM Mgr., Director of Managed Care and the Chief of Managed Care. Essential Duties and Responsibilities: Includes the following.  Other duties may be assigned. Pre-admission, concurrent and retrospective acute care, sub-acute, hospice, transitional care & long term care to determine whether or not an admission is, or remains to be, reasonable and medically necessary, using established criteria, e.g., Milliman and Robertson, InterQual, Medicare or Medicaid, or AHF Best Practice criteria Performs case reviews in a timely manner and maintains all required documentation of clinical reviews in the appropriate database.  Issues authorizations to Providers and assists Plan Medical Director in the issuance of other required communications (such as denials) per established guidelines, and in compliance with all applicable Medicare or Medicaid guidelines. Collaborates with the Primary Care Provider and/or attending physician, internal and external case managers, patient and/or family and other healthcare providers to provide continuity and quality of care in the most cost effective manner Assists in the discharge planning process with both internal and external case managers/discharge planners and/or patient and family. Concurrent Review and collaboration with internal case managers of all acute care, skilled nursing, acute rehabilitation, long term care, hospice and home with home care services admissions of Plan members. Assesses each acute care hospital admission to determine the appropriate level of care, i.e., critical care, telemetry, step down, medical-surgical, administrative, etc. Admission Reviews are performed within 72 hours of admission (for weekend admissions) and within 48 hrs. of all other admission, or as dictated by applicable policy and procedure. Monitors and maintains Hospitalization Reports at the direction of UM/CM Mgr. May attend clinical meetings with hospital based providers and staff regarding the care of plan members. Coordinates closely with the Plan’s Medical Director, referring cases that do not appear to meet established criteria. Compiles and analyzes data for utilization review management activities. Maintains logs and statistics as directed by UM/CM Mgr. Provides outpatient or pharmacy services utilization review, based on UM/CM Dept. needs. Prepares or assists in preparing  weekly, monthly, quarterly and yearly and ad hoc utilization review reports as directed by UM/CM Mgr. Assists in preparing an annual Utilization Management Program evaluation. Participation in AHF Meetings/Committees Attends AHF meetings as assigned. Supervisory Responsibilities This job has no supervisory responsibilities.   Qualifications: To perform this job successfully, an individual must be able to satisfactorily perform the essential duties.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Current Florida RN license 3 or more years of recent medical/surgical or critical care nursing experience 3 or more years of recent Utilization Review/Case Management Experience Strong telephonic communication skills, ability to conduct high level clinical discussions with physicians and nurses Ability to successfully work with various levels of professional staff; must work well independently and as part of a team Language Skills Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.   Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs. College level algebra and statistics Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Aids Healthcare Foundation Fort Lauderdale, FL 33301, United States
Jan 05, 2018
Full time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!   Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?   If so, AIDS Healthcare Foundation is the place for you!   Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.    AHF’s core values are:   • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right     STILL INTERESTED? Please continue!     Responsibilities: Essential Duties & Responsibilities Includes the following.  Other duties may be assigned . Maintains clinical competency, as demonstrated in providing and directing patient care. Assures that nursing staff practice within their individual scopes of practice. Assists and communicates with medical staff concerning patient care issues (e.g., change in condition, refill requests, patient incidents). Assesses and Triages patients. Participates in the case management of individual patients to ensure the continuity of care. Develops and oversees internal working systems relevant to the medical/nursing operations within a clinic setting. Produces required reports on a timely basis. Maintains compliance with DHS, County Public Health, and other regulatory agencies, statutes and standards. Directs nursing care in a manner reflective of the philosophy of AIDS Healthcare Foundation. Provides education to patient and patient's personal support system in areas such as disease management, safe sex, etc. Assumes supervisory duties such as performance evaluations, counseling and progressive discipline of the nursing staff. Complies with safety standards and infection control standards. Promotes team work, good interpersonal relations and communication among staff at the healthcare setting and corporate level. Participates in nursing staff orientation and serves as a clinical resource. Plans and participates in educational programs for the nursing staff. Oversees and controls supplies that directly impact patient care (e.g. ordering and charging stock medications, medical supplies and patient care equipment and/or supplies. Exercises appropriate judgment and good decision-making skills. Assumes additional responsibilities as necessary (i.e., assisting the nursing staff at times of critical need, attendance at all assigned committees). Participation in AHF Meetings/Committees Attends Nurse Managers Meeting. Attends Leadership Meeting. Attends HCC Staff Meeting. Attends other meetings as assigned. Supervisory Responsibilities Carries out supervisory responsibilities in accordance with AHF’s policies and applicable laws.  Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work, appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.    Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN program. BSN preferred. Computer/Software Skills & Abilities To perform this job successfully, an individual should have knowledge of word processing software.    Language Skills Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents.  Ability to respond to common inquiries or complaints from customers, regulatory agencies or members of the business community.  Ability to write speeches and articles for publication that conform to prescribed style and format.  Ability to effectively present information to top management, public groups, and/or boards of directors.   Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs.   Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.   Other Skills & Abilities/Qualifications Knowledge of HIV/AIDS and related medical and patient care issues and concerns in diverse populations. Previous administrative and supervisory experience preferred. Strong clinical nursing skills. Demonstrated proficiency in phlebotomy and intravenous insertion, care and therapy. Fluent in conversational Spanish preferred. Understanding of case management and benefits preferred. Ability to work at various healthcare centers.  Certificates, Licenses and Registrations Current State RN License in applicable working location. Current CPR certification (Healthcare Provider). Valid Driver License in state of employment, with proof of liability insurance. We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.
Aids Healthcare Foundation Fort Lauderdale, FL 33301, United States
Jan 05, 2018
Full time
Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?   If so, AIDS Healthcare Foundation is the place for you!   Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.    AHF’s core values are:   • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right     STILL INTERESTED? Please continue!     Responsibilities: Essential Duties & Responsibilities Includes the following.  Other duties may be assigned . Maintains clinical competency, as demonstrated in providing and directing patient care. Assures that nursing staff practice within their individual scopes of practice. Assists and communicates with medical staff concerning patient care issues (e.g., change in condition, refill requests, patient incidents). Assesses and Triages patients. Participates in the case management of individual patients to ensure the continuity of care. Develops and oversees internal working systems relevant to the medical/nursing operations within a clinic setting. Produces required reports on a timely basis. Maintains compliance with DHS, County Public Health, and other regulatory agencies, statutes and standards. Directs nursing care in a manner reflective of the philosophy of AIDS Healthcare Foundation. Provides education to patient and patient's personal support system in areas such as disease management, safe sex, etc. Assumes supervisory duties such as performance evaluations, counseling and progressive discipline of the nursing staff. Complies with safety standards and infection control standards. Promotes team work, good interpersonal relations and communication among staff at the healthcare setting and corporate level. Participates in nursing staff orientation and serves as a clinical resource. Plans and participates in educational programs for the nursing staff. Oversees and controls supplies that directly impact patient care (e.g. ordering and charging stock medications, medical supplies and patient care equipment and/or supplies. Exercises appropriate judgment and good decision-making skills. Assumes additional responsibilities as necessary (i.e., assisting the nursing staff at times of critical need, attendance at all assigned committees). Participation in AHF Meetings/Committees Attends Nurse Managers Meeting. Attends Leadership Meeting. Attends HCC Staff Meeting. Attends other meetings as assigned. Supervisory Responsibilities Carries out supervisory responsibilities in accordance with AHF’s policies and applicable laws.  Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work, appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.    Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN program. BSN preferred. Computer/Software Skills & Abilities To perform this job successfully, an individual should have knowledge of word processing software.    Language Skills Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents.  Ability to respond to common inquiries or complaints from customers, regulatory agencies or members of the business community.  Ability to write speeches and articles for publication that conform to prescribed style and format.  Ability to effectively present information to top management, public groups, and/or boards of directors.   Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs.   Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.   Other Skills & Abilities/Qualifications Knowledge of HIV/AIDS and related medical and patient care issues and concerns in diverse populations. Previous administrative and supervisory experience preferred. Strong clinical nursing skills. Demonstrated proficiency in phlebotomy and intravenous insertion, care and therapy. Fluent in conversational Spanish preferred. Understanding of case management and benefits preferred. Ability to work at various healthcare centers.  Certificates, Licenses and Registrations Current State RN License in applicable working location. Current CPR certification (Healthcare Provider). Valid Driver License in state of employment, with proof of liability insurance. We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.
Aids Healthcare Foundation Fort Lauderdale, FL 33301, United States
Jan 05, 2018
Full time
Responsibilities: Summary The RN Care Team Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida. Key responsibilities include leading the care team which provides culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the RN Care Team Manager, participating in the gathering and transmission of information and data to the RN Care Team Manager for assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.    Essential Duties & Responsibilities Duties and Responsibilities include but are not limited to: • Collaborates with and plays a lead role with Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. • Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. • Responsible to manage and coordinate care for an assigned population of Level 3, high risk members. • Orients new members to the Managed Care program through Welcome and Transition calls. • Completes assessments and re-assessments timely for members assigned to the Care Team. • With the member, establishes patient centered long term and short term goals for care and self management. • With the input of the member, family and medical team, creates an appropriate and timely individual care plan to assist the member to achieve the established goals. • Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wrap around solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. • Works to deliver care management services in an efficient and cost effective manner. • Performs PAC assessments and exception request visits as requested  • Adheres to PAC Manual when delivering PAC assessment or reassessment services.  • Communicates the care plan to the Primary Care Physician, member and others in the Health Home. • Revises the Care Plan as needed and at a minimum following hospitalization of the member or following the annual re-assessment. • Meets with patients face to face in the home or at physician appointments to complete assessments and other contacts, as necessary. • With the support of the Care Team,  re-engages the member following hospital admissions and emergency room use through reassessment, coordination of transition of care, including PCP appointment and transportation as needed. • Monitors the appropriate use of outpatient ancillary services, medication adherence, compliance to PCP visit schedules and results of lab work. • Provides Transition of Care follow-up visits or calls to patients following change in level of care. • Provides health education regarding disease process, medications, medication adherence, community resources and benefits. • Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. • Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. •  Maintains at least the minimum performance and productivity standards. • Completes a minimum of three recommended AIDS related in-services, trainings or conferences per year. o Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency • Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. • Advocates for member needs with medical provider, RN Care Team Manager and community. • Reports all complaints and grievances per grievance policy. • Other duties as assigned to ensure team goals are met. Management Responsibilities Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Supervises and delegates appropriate tasks to the LPN Care Partner, the Care Coordinator and the Social Worker and monitors for the appropriate completion of assigned tasks. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management on member clinical, satisfaction, utilization and cost issues. Signs off on Care Plans developed by the LPN Care Partner.   Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN Program. BSN preferred.  At least five years clinical experience and three years Case Management, Community nursing, Home Health or Hospice nursing desired Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification within two years of employment. Certified in AIDS Care or eligible for ANAC certification within three years of employment.   Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.  Language Skills Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues   Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing..  Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables.   Travel:  Over 50% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, and AHF office.  Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a leader or member  of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred  Certification in case management preferred  Current CPR (Cardio Pulmonary Resuscitation) Certificate Required Valid Florida Driver’s License with proof of automobile liability insurance   We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.
Aids Healthcare Foundation Washington, DC 20001, United States
Jan 05, 2018
Full time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are: • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right   STILL INTERESTED? Please continue!     Responsibilities:   The Ryan White Registered Nurse Medical Case Manager (MCM) contributes to the success of the Medical Care Management Programs by managing the daily work flow to achieve high quality care management delivery and positive clinical outcomes, promote client retention in care, adherence to prescribed medical and medication therapies, while meeting the administrative and contractual performance targets, documentation standards and billing requirements of the  Medical Care Management Programs.   In addition: The RN Medical Case Manager provides case management services to manage and maintain patients in care in order to improve health outcomes. Provide a link for clients to appropriate entitlement and support services and serves as a portal for critical client education. The MCM screen cases for possible case management services according to the contract and RW jurisdiction’s predetermined criteria, evaluates physician's treatment plan and other records to develop a care plan to assist patient to maintain adherence to medications, appointments and other medical follow up, consults with providers, clients and family members as needed, documents all initial and concurrent reviews, including, but not limited to diagnosis, symptoms, interventions, goals and plan for next review Essential Duties & Responsibilities To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Includes the following.  Other duties may be assigned. Maintains extensive knowledge regarding the current standards of HIV/AIDS care and case management processes. Attends all required educational events, e.g., HIPAA, Fraud/Waste/Abuse, Cultural and Linguistic Sensitivity, DOH-HASTA trainings, and HIV updates. Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management. Maintains current knowledge of the District HIV Medical Case Management Guidelines, 2014 second edition or newer. Interviews patients and families to assess needs and risk categories to develop and implement appropriate plans of care and assessments Establishes long and short term goals for the patient/family which are S-M-A-R-T  (Smart, Measurable, Achievable, Realistic, Timely) Creates an individualized plan of action in collaboration with the patient, family, medical caregivers and community agencies.  Implements, monitors and evaluates the plan of care and its effectiveness.  Revises as necessary. Monitors hospital, emergency room, outpatient and ancillary services; lab values and patient satisfaction to determine program effectiveness. Educates patients regarding the disease process and medications, methods for improving medication compliance, available community resources and other pertinent information. Reviews medical records to identify needs and tracks outcomes.  Updates plans of care (ISP) as required and as needed. Performs reassessments as required by contractual/DOH HIV MCM Guideline requirements Utilizes the 104 day report to conduct outreach by phone and/or home visits to recapture and retain patients in care.   Assures all Department of Health (DOH) -HASTA jurisdiction MCM acuity driven client contacts targets are met and documented per HIV MCM Guidelines.  Assures all clients enrolled in the HIV MCM program meet RW DOH-HASTA eligibility criteria when services are delivered. Continually strives to meet the goals of the HIV MCM program when working with clients: •    Taking all medications as prescribed •    Making and keeping of medical and case management appointments •    Addressing barriers to care and treatment •    Adapting to therapeutic lifestyle changes as necessary   Collaborates with ASO’s and other community services in the Eligible Metropolitan Area (EMA), including specialty care providers, as necessary to ensure appropriate access to services and follow-up on the results to such referrals. Conducts home visits, when necessary to identify barriers and/or facilitate care management. Documents effectively in the computer system and tracks outcomes of care on an individual and aggregate basis regarding the patient and provider population. Updates CareWare information as appropriate. Updates the GAIN SS surveys per DOH and HASTA requirements Enters all documentation of activities in the computer system within 48 hours of performance of said activities. Conduct training for other associates regarding the overall Case Management Program and specific processes such as the case management referral process. Maintains detailed record of time spent providing service to each patient and submits this information at regular intervals for timely billing. Monitors patient’s acuity level in an ongoing fashion to ensure disenrollment when patient is no longer an acuity level that  necessitates case management, In DC monitor the Acuity Tool and establishes Clients needs from the Acuity Score, and follows patient accordingly.  Provides feedback to the referring provider regarding planned disenrollment from program. Participates in local EMA functions in the community and scheduled HASTA meetings. Participates and/or leads quality improvement activities as assigned. Assists in tracking, resolving and reporting of complaints/grievances. Maintains information in a confidential manner at all times. Supervises and monitors the duties and responsibilities assigned to the Medical Care Coordinator. Directs and monitors peer navigators activates to assist in returning members who have been lost to care Participation in AHF Meetings/Committees Monthly staff meeting Interdisciplinary Team meetings Quality Improvement meetings Grant Overview meetings Attends other meetings as required within AHF Attends County Meetings as they pertain to MCM in DC Attends Planning Council meetings Supervisory Responsibilities The RN MCM supervises the Medical Care Coordinator. As the RN Medical Case Manager, the RN MCM will oversee and monitor the assessments of the Medical Care Coordinator. The RN MCM will collaborate with the Medical Care Coordinator to ensure all reassessments have been conducted, all follow up phone calls are done on a timely manner and review all new patients with the Medical Care Coordinator as this is important for continuity of care and patient follow up.   Job Requirements: Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requirements •    RN licensure and three (3) years clinical practice experience and practice case management within the scope of their licensure (based on the standards of the discipline). •    A Bachelors Degree in Nursing (preferred). •    Certification as a Case Manager within 12 months of employment  •    ACRN within 18 months of employment  Education Graduate of an accredited professional Nursing program, BSN Degree preferred.   Certificates, Licenses and/or Registrations Valid Washington DC Registered Nurse license  Certified in Case Management (CCM) within 12 months of employment AIDS Certified Registered Nurse within 18 months of employment Current CPR Certification Current driver’s license with proof of liability insurance. Experience •    3 or more years’ clinical experience in a health care environment. •    A minimum of one year experience working within HIV case management or relevant adult community health, clinical or hospital based environment.  Other Skills & Abilities/Qualifications:  •    Demonstrated ability for assessment, evaluation and interpretation of medical information.  •    Skilled in the operation of the computer including proficiency in Microsoft Office Word, Excel and Access.  •    Should have a high level of understanding of community resources, treatment options, home health availability, funding options and special programs. •    Preferred knowledge of HIV/AIDS and related issues as they relate to a diverse population. •    Bi-lingual preferred. •    Must be able to travel up to 25% of the time within the community to make personal visit to patient’s home, hospitals and/or healthcare centers. Computer/Software Skills & Abilities To perform this job successfully, an individual should have knowledge of Word Processing software. Language Skills Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Mathematical Skills Intermediate Skills:  Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.  Ability to apply concepts of basic algebra and geometry. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Aids Healthcare Foundation Los Angeles, CA 90028, United States
Jan 05, 2018
Full time
The Utilization Management Registered Nurse (UMRN) is responsible for projecting and integrating the Mission and Core Values of the organization in the provision of utilization  management services to members and medical providers of AIDS Healthcare Foundation’s Medicare Health Plan, MediCal Health Plan and where designated, Ryan White Programs.   Key responsibilities of the UMRN include but are not limited to: ·         Making decisions as to the level of care necessary and appropriate for the patients, whether to approve or present for modification or denial to the Medical Director specific admissions to acute or skilled facilities, modes of inpatient or outpatient treatment, diagnostic testing or medications.  Such decisions may cover the health plan members as well as uninsured or underinsured patients within the AHF managed care environment.  ·         To reduce fragmented care and readmissions by coordinating the patient, patient care givers, inpatient discharge team and next level of care transitioning interdisciplinary team needed to implement the patient-centered transition from the acute or skilled nursing facility to the next level of care after an episode of illness or medical intervention. ·         Applying professional, national, contractual, regulatory, and Plan standards to utilization management decisions on a consistent and non-biased patient centered manner. ·         Concurrent Review and collaboration with case managers at the acute care setting, skilled nursing facilities, acute rehabilitation units, long term care facilities and hospice care.  Obtains appropriate facility assessment or certification documents as required by each level of care and incorporates into the utilization management plan for the individual patient, e.g. National Coverage Determinations, MDS SNF Evaluation, Hospice Certification/Recertification, etc.  ·         Maintenance of current Medicare and MediCal regulation and requirement knowledge for: ·         Skilled nursing pre-admission evaluation, admission evaluation, continued skilled stay necessity review. ·         Long term care admission evaluation, interval assessment and continued stay requirements. ·         Organizational determinations, reconsiderations, expedited reviews, Independent Review Entity (IRE) reconsiderations, QIO review of coverage terminations, appeals, etc. ·         Hospice benefit initial certification and benefit period certification, levels of hospice services and coordination of Medicare/MediCal non-hospice services where necessary. Education and/or Experience: ·         Graduate from an accredited RN Program. ·         3 or more years of acute hospital experience with adults in medical/surgical, critical care or ER ·         HIV/AIDS nursing experience desired. ·         2 or more years of recent Utilization Review/Case Management experience required. ·         Medicare and MediCal Utilization Management knowledge.  ·         Managed Care experience a plus. Certification and Licenses: ·         Must have California  RN License (without restrictions) ·         Current California RN License. ·         Current Driver’s License with proof of liability insurance. ·         CPUR, CPUM or CPHM within 15 months of employment.   We offer competitive salary commensurate with experience, benefits, bonus incentives and an amazing work environment.   Submit a recent copy of your CV to Cristina.deleon@aidshealth.org or call (323) 337-9148.  Visit our website at www.aidshealth.org
Aids Healthcare Foundation South Beach, FL 33139, United States
Jan 05, 2018
Full time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!   Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?   If so, AIDS Healthcare Foundation is the place for you!   Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.    AHF’s core values are to be:   • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right     STILL INTERESTED? Please continue!   Responsibilities: Job Summary The Ryan White (RW) RN Medical Case Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision case management services to patients of the AIDS Healthcare Foundation (AHF) Miami/Dade Healthcare Centers (HCCs). Key responsibilities include leading the case management team which provides culturally and linguistically sensitive cade management services to the HIV/AIDS  patient population who are eligible for  Ryan White services.  The RNMCM assesses the patients and works collaboratively  with the patients, their medical provider, designated family/significant others and community support service providers to address the needs identified in the patient’s health and psychosocial risk assessment and implement a plan of care based upon the needs identified.  The RN MCM coordinates care planning, the scheduling of interdisciplinary team meetings, the identification of referral sources, provides referral an follow-up, oversight of the Peer Navigators, eligibility screening, and participates in activities that increase understanding of the communities served by the AHF HCCs.  The RNMCM is responsible meeting the RW Medical Case Management Standards for Miami/Dade and for the patient specific health education, monitoring and deployment of techniques to assure the engagement and retention in care of the RW patients as well as their medication usage knowledge and adherence to antiretroviral (ARV) and chronic medication regimens goals are met.   Essential Duties & Responsibilities Includes the following.  Other duties may be assigned. Maintains extensive knowledge regarding the current standards of HIV/AIDS care and case management processes. Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management. Schedules HIV/AIDS 104 taught by Department of Health within 30 calendar days of hire and completes the course within 60 days of hire. Attends  21 hours annually of monthly Miami-Dade Ryan White system-wide case management related training. • RN MCMs with less than two (2) years in the Ryan White  Program System must attend 16 hours of basic case management training.  The basic training is not part of the annual 21 hours MCM training.  The RNMCM completes and passes proficiency test based on the above required Miami-Dade Ryan White training within 6 months of hire and subsequently every 3 years. Ensures a comprehensive eligibility and financial assessment is conducted within five (5) days of and every six months thereafter. Completes a comprehensive individualized needs and health risk assessment within the Miami/Dade MCM Standards of Care time frame.  Develops a Plan of Care (POC) based upon the health and needs assessment at time of intake and once annually thereafter. Interviews patients and families to assess needs and risk categories to develop and implement appropriate plans of care.  Documents interviews in PosiTrak© and SDIS as required. Establishes long and short term goals for the patient/family which are S-M-A-R-T  (Smart, Measurable, Achievable, Realistic, Timely) Implements, monitors and evaluates the plan of care and its effectiveness.  Revises when necessary. Monitors hospital, emergency room, outpatient and ancillary services, lab values and patient satisfaction to determine program effectiveness. Educates patients regarding the HIV/AIDS and co-morbid condition disease processes, provider visit adherence, methods for improving medication adherence, self-directed health care , available community resources and other pertinent information. Reviews medical records to identify needs and tracks outcomes. Collaborates with ASO’s and other community services in the Eligible Metropolitan Area (EMA), including specialty care providers, as necessary to ensure appropriate access to services and follow-up on the results to such referrals. Documents effectively in the PosiTrak computer system and tracks outcomes of care on an individual and aggregate basis regarding the patient and provider population. Documents the contractual and MCM Standards of Care  required information in SDIS computer system and tracks outcomes of care on an individual and aggregate basis regarding the patient and provider population. Maintains detailed record of time spent providing service to each patient and submits this information at regular monthly intervals to Grant Manager for timely billing. Participates in the quarterly client care reviews and ongoing Quality Improvement activities. Provides feedback to the referring provider regarding planned disenrollment from program. Participates in local EMA functions in the community. Educates clients on accessing the complaint and grievance system.  Assures complaints/grievances are filed through AHF Member Services to assure the tracking and resolution of complaints and grievances. Completes HIPAA and Fraud, Waste and Abuse (FWA) training within 30 days of hire.  Complies with AHF HIPAA and FWA policies and procedures.  Reports all breaches to Chief Counsel for Operations.  Maintains information in a confidential manner.   Participation in AHF Meetings/Committees Quality Management Committee Interdisciplinary Rounds MCM Operations Committee Other meetings as assigned   Supervisory Responsibilities Provides guidance and oversight to Peer Counselors Job Requirements: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience Bachelor’s degree in in Nursing (BSN) with 6 months of case management experience. Knowledge of HIV/AIDS disease and HIV/AIDS Miami-Dade service delivery preferred. Computer/Software Skills & Abilities To perform this job successfully an individual should have knowledge of MS Office Word, Microsoft Access, Microsoft Outlook, and Microsoft Excel s software, and Contact Management software a plus. Language Skills Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Other Skills & Abilities/Qualifications Minimum one year managed care and case management experience. Excellent written and verbal communication skills. Excellent organizational skills. Knowledge of ICD-9 Coding. Clinical experience in the care of people with HIV/AIDS. Must be able to travel 50% of the time. Certificates, Licenses and Registrations Registered Nurse licensed by the State of Florida with a Baccalaureate Degree in Nursing. Valid Florida Driver’s License with proof of automobile liability insurance. Certification in case management preferred. AIDS Certified Registered Nurse preferred.
Aids Healthcare Foundation Fort Lauderdale, FL 33301, United States
Jan 05, 2018
Full time
Summary: Utilization Review is the process in which medical review determinations are made based on clinical guidelines and structured processes. This position reviews the utilization of the organization/plan’s resources against established criteria, monitors and evaluates the medical necessity, appropriateness and efficient use of health care services.   The UM/Transition of Care RN is responsible for projecting and integrating the Mission and Core Values of the organization in the provision of care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida.   Key responsibilities include leading the transition of care process, providing culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the Utilization Manager, participating in the gathering and transmission of information and data to the RN Care Team Manager for assessment, re-assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.    Responsibilities: Duties and Responsibilities include but are not limited to: •    The Transition of Care UM Nurse is responsible for projecting and integrating the Mission and Core Values of the organization within and outside of the Managed Care Department. •    Collaborates with transitioning facility staff to assure discharge planning and physician discharge orders have been implemented and confirmed as executed prior to the patient’s discharge •    Concurrent acute care, sub-acute, hospice, transitional care & long term care to determine whether or not an admission is, or remains to be, reasonable and medically necessary, using established criteria, e.g., InterQual, Medicare or Medicaid, or AHF Best Practice criteria •    Collaborates with the Primary Care Provider and/or attending physician, internal and external case managers, patient and/or family and other healthcare providers to provide continuity and quality of care in the most cost effective manner •    Assists in the discharge planning process with both internal and external case managers/discharge planners and/or patient and family. •    Concurrent Review and collaboration with internal case managers of all acute care, skilled nursing, acute rehabilitation, long term care, hospice and home with home care services admissions of Plan members. •    Provides feedback related to each acute care hospital admission to determine the appropriate level of care, i.e., critical care, telemetry, step down, medical-surgical, administrative, etc. •    Collaborates with and plays a lead role to re-engage the member during and following a medical, rehabilitation and behavioral inpatient admission through reassessment, coordination of transition of care, including PCP appointment, supplies, services and transportation as needed •    Provides transition of care visits in the inpatient setting to educate the patient, when consented to by the patient, the family/significant other on their discharge plan, i.e., what to expect,  medications prescribed, what they were prescribed for and how to take them, reconciling pre and post hospitalization medication lists, keeping personal health record/notes and what and when to report symptoms to the UM/TOC nurse, RNCTM or PCP,  as well as conducting  follow-up home/ transition facility visits and calls to patients following the transition to a new level of care to assure plan is progressing and  PCP visit has occurred. •    Intercedes directly on member behalf when necessary to assure smooth transition process, e.g., assuring delivery of prescription medications, authorizing care/services based upon indications and appropriateness of care criteria, substituting home health vendors when care or supply commitments for transition are not met, etc. •    Collaborates with the Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. •    Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. •    Completes assessments and re-assessments timely for members as needed during transition of care, updates RNCTM on assessment findings, discharge plan and changes to patient individual care plan. •    With the member, establishes and updates patient centered long term and short term goals for care and self-management. •    With the input of the member, family and medical team, creates an appropriate and timely individual and updates care plan to assist the member to achieve the established goals. •    Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wraparound solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. •    Works to deliver care management services in an efficient and cost effective manner. •    Communicates the care plan to the Primary Care Physician, member and others in the Health Home. •    Revises the Care Plan following hospitalization of the member or following the annual re-assessment. •    Meets with patients face to face in the home or at physician appointments to complete transition of care assessments, surveys and other contacts, as necessary. •    Provides health education regarding disease process, medications, medication adherence, community resources and benefits. •    Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. •    Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. •     Maintains at least the minimum performance and productivity standards. •    Completes a minimum of three recommended AIDS related in-services, trainings or one conference per year. o    Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency •    Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. •    Advocates for member needs with medical provider, RN Care Team Manager and community. •    Reports all complaints and grievances per grievance policy. •    Prepares or assists in preparing  weekly, monthly, quarterly and yearly and ad hoc utilization review reports as directed by UM Manager. •    Other duties as assigned to ensure team goals are met. Management Responsibilities Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management regarding member clinical, satisfaction, utilization and cost issues. Job Requirements: To perform this job successfully, an individual must be able to satisfactorily perform the essential duties.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience Graduate from an accredited RN program required BS in Nursing preferred At least five years clinical experience and three years Case Management, Community nursing, Home Health or Hospice nursing desired Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification with one year of employment. Certified in AIDS Care or eligible for ANAC certification within one year of employment Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.   Language Skills Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues   Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing..  Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables.   Travel Over 80% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, other health venues and AHF offices.   Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work and communicate effectively with various levels of professional (e.g., physicians, professional nurses, licensed psycho-social professionals, licensed healthcare professionals health care administrators, etc.) and non-professional staff/external individuals (non-licensed allied health personnel, lay case managers, care coordinators, family/significant others, etc.). Ability to successfully mediate conflicts between individuals or groups Must be able to work independently and as a leader or member of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred  Certification in case management preferred  Valid Florida Driver’s License with proof of automobile liability insurance    We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.
Aids Healthcare Foundation Jacksonville, FL 32099, United States
Jan 05, 2018
Full time
Summary   The RN Care Manager/UMRN is responsible for projecting and integrating the Mission and Core Values of the organization in the provision care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida.   Key responsibilities include leading the care needs of members which provides culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the RN Care Manager, participating in the gathering and transmission of information and data to the RN Care Manager for assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.  This roles will also oversee Um functions related to the service area including precertification process.   Responsibilities: Duties and Responsibilities include but are not limited to: •    Collaborates with and plays a lead role with Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. •    Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. •    Responsible to manage and coordinate care for an assigned population of Level 3, high risk members. •    Orients new members to the Managed Care program through Welcome and Transition calls. •    Completes assessments and re-assessments timely for members assigned to the Care Team. •    With the member, establishes patient centered long term and short term goals for care and self management. •    With the input of the member, family and medical team, creates an appropriate and timely individual care plan to assist the member to achieve the established goals. •    Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wrap around solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. •    Works to deliver care management services in an efficient and cost effective manner. •    Performs PAC assessments and exception request visits as requested  •    Adheres to PAC Manual when delivering PAC assessment or reassessment services.  •    Communicates the care plan to the Primary Care Physician, member and others in the Health Home. •    Revises the Care Plan as needed and at a minimum following hospitalization of the member or following the annual re-assessment. •    Meets with patients face to face in the home or at physician appointments to complete assessments and other contacts, as necessary. •    With the support of the Care Team,  re-engages the member following hospital admissions and emergency room use through reassessment, coordination of transition of care, including PCP appointment and transportation as needed. •    Monitors the appropriate use of outpatient ancillary services, medication adherence, compliance to PCP visit schedules and results of lab work. •    Provides Transition of Care follow-up visits or calls to patients following change in level of care. •    Provides health education regarding disease process, medications, medication adherence, community resources and benefits. •    Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. •    Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. •     Maintains at least the minimum performance and productivity standards. •    Completes a minimum of three recommended AIDS related in-services, trainings or conferences per year. o    Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency •    Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. •    Advocates for member needs with medical provider, RN Care Team Manager and community. •    Reports all complaints and grievances per grievance policy. •    Other duties as assigned to ensure team goals are met. Management Responsibilities Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Supervises and delegates appropriate tasks to the LPN Care Partner, the Care Coordinator and the Social Worker and monitors for the appropriate completion of assigned tasks. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management on member clinical, satisfaction, utilization and cost issues. Signs off on Care Plans developed by the LPN Care Partner. Job Requirements: Qualifications: To perform this job successfully, an individual must be able to satisfactorily perform the essential duties.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience Graduate from an accredited RN program required BS in Nursing preferred At least five years clinical experience and three years Case Management, Community nursing, Utilization review process understanding Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification within two years of employment. Certified in AIDS Care or eligible for ANAC certification within three years of employment Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.   Language Skills Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues   Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing..  Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables. Travel Over 50% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, and AHF office.   Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a leader or member  of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred  Certification in case management preferred  Current CPR (Cardio Pulmonary Resuscitation) Certificate Required Valid Florida Driver’s License with proof of automobile liability insurance
Aids Healthcare Foundation Jacksonville, FL , United States
Jan 05, 2018
Full time
Summary   The RN Care Manager/UMRN is responsible for projecting and integrating the Mission and Core Values of the organization in the provision care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida.   Key responsibilities include leading the care needs of members which provides culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the RN Care Manager, participating in the gathering and transmission of information and data to the RN Care Manager for assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.  This roles will also oversee Um functions related to the service area including precertification process.   Responsibilities: Duties and Responsibilities include but are not limited to: •    Collaborates with and plays a lead role with Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. •    Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. •    Responsible to manage and coordinate care for an assigned population of Level 3, high risk members. •    Orients new members to the Managed Care program through Welcome and Transition calls. •    Completes assessments and re-assessments timely for members assigned to the Care Team. •    With the member, establishes patient centered long term and short term goals for care and self management. •    With the input of the member, family and medical team, creates an appropriate and timely individual care plan to assist the member to achieve the established goals. •    Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wrap around solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. •    Works to deliver care management services in an efficient and cost effective manner. •    Performs PAC assessments and exception request visits as requested  •    Adheres to PAC Manual when delivering PAC assessment or reassessment services.  •    Communicates the care plan to the Primary Care Physician, member and others in the Health Home. •    Revises the Care Plan as needed and at a minimum following hospitalization of the member or following the annual re-assessment. •    Meets with patients face to face in the home or at physician appointments to complete assessments and other contacts, as necessary. •    With the support of the Care Team,  re-engages the member following hospital admissions and emergency room use through reassessment, coordination of transition of care, including PCP appointment and transportation as needed. •    Monitors the appropriate use of outpatient ancillary services, medication adherence, compliance to PCP visit schedules and results of lab work. •    Provides Transition of Care follow-up visits or calls to patients following change in level of care. •    Provides health education regarding disease process, medications, medication adherence, community resources and benefits. •    Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. •    Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. •     Maintains at least the minimum performance and productivity standards. •    Completes a minimum of three recommended AIDS related in-services, trainings or conferences per year. o    Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency •    Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. •    Advocates for member needs with medical provider, RN Care Team Manager and community. •    Reports all complaints and grievances per grievance policy. •    Other duties as assigned to ensure team goals are met. Management Responsibilities Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Supervises and delegates appropriate tasks to the LPN Care Partner, the Care Coordinator and the Social Worker and monitors for the appropriate completion of assigned tasks. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management on member clinical, satisfaction, utilization and cost issues. Signs off on Care Plans developed by the LPN Care Partner.   Qualifications: To perform this job successfully, an individual must be able to satisfactorily perform the essential duties.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience Graduate from an accredited RN program required BS in Nursing preferred At least five years clinical experience and three years Case Management, Community nursing, Utilization review process understanding Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification within two years of employment. Certified in AIDS Care or eligible for ANAC certification within three years of employment Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.   Language Skills Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues   Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing..  Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables. Travel Over 50% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, and AHF office.   Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a leader or member  of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred  Certification in case management preferred  Current CPR (Cardio Pulmonary Resuscitation) Certificate Required Valid Florida Driver’s License with proof of automobile liability insurance   We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.
Aids Healthcare Foundation Fort Lauderdale, FL , United States
Jan 05, 2018
Full time
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!   Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?   If so, AIDS Healthcare Foundation is the place for you!   Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.    AHF’s core values are to be:   • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right     STILL INTERESTED? Please continue! AHF is currently seeking a Full Time LPN for our Northpoint Healthcare Center in Fort Lauderdale. The hours of operations are Monday, Tuesday, Thursday and Friday 8 AM to 5 PM and Wednesdays 11 AM to 7 PM. We offer a competitive salary, amazing benefits and a great work environment. A bilingual candidate is preferred but not required to apply.     Responsibilities: Essential Duties & Responsibilities Includes the following.  Other duties may be assigned.   Documents patient's weight, temperature, pulse, respiration and blood pressure at patient healthcare visit as ordered or per protocol. Collects samples such as urine, blood, and stool specimens in the Healthcare Centers as ordered and instructs patients in home collection of urine, stool and sputum specimens, when appropriate Performs phlebotomy as ordered and prepares specimens for transport to laboratory. Documents services performed for compliance and reporting purposes. Reviews physician orders, lab requests or follow-up needs with patient. Collaborates with other nursing personnel and participates as a team member.  May receive laboratory results over the telephone and transmit them to the Nurse Manager and the patient's medical provider in a timely manner. Administers Purified Protein Derivative (PPD), as ordered. Determines results. Administers controlled medication and documents appropriately. Reports changes in patient's physical status to the Nurse Manager or medical provider. Assists physician with examinations and procedures as assigned. Documents observations as requested by an MD and/or Nurse Manager in the patient's medical record. Receives and processes medication refill requests; verifies medication requests with healthcare provider and obtains appropriate documentation. Ensures maintenance of patient confidentiality. Maintains supplies and cleanliness of examination rooms. Maintains logs as directed by the Nurse Manager. Maintains standard precautions for infection control.   Participation in AHF Meetings/Committees Meetings as assigned.   Supervisory Responsibilities This job has no supervisory responsibilities.   Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience High school diploma or general education degree (GED);  graduate of an accredited licensed pracital nurse program.  Minimum of two years related experience and/or training. Computer/Software Skills & Abilities Proficiency in word processing and basic data base programs.Proficiency in Logician/EMR (training and continuing education will be provided in house). Language Skills Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization. Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.   Other Skills & Abilities/Qualifications Communicates in a tactful and professional manner. Bilingual (English/Spanish) highly desirable. Experience and sensitivity in working with individuals affected by HIV/AIDS. Certificates, Licenses and Registrations Valid Florida L.P.N. License, without restrictions. Valid C.P.R. certification. Certificate in phlebotomy and intravenous (IV) therapy; certification must be presented upon hire or prior to the completion of the initial 90-day introductory period.   We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.
Aids Healthcare Foundation Fort Lauderdale, FL , United States
Jan 05, 2018
Full time
Summary The RN Care Team Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida. Key responsibilities include leading the care team which provides culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the RN Care Team Manager, participating in the gathering and transmission of information and data to the RN Care Team Manager for assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.   Responsibilities: Essential Duties & Responsibilities Duties and Responsibilities include but are not limited to: • Collaborates with and plays a lead role with Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. • Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. • Responsible to manage and coordinate care for an assigned population of Level 3, high risk members. • Orients new members to the Managed Care program through Welcome and Transition calls. • Completes assessments and re-assessments timely for members assigned to the Care Team. • With the member, establishes patient centered long term and short term goals for care and self management. • With the input of the member, family and medical team, creates an appropriate and timely individual care plan to assist the member to achieve the established goals. • Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wrap around solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. • Works to deliver care management services in an efficient and cost effective manner. • Performs PAC assessments and exception request visits as requested  • Adheres to PAC Manual when delivering PAC assessment or reassessment services.  • Communicates the care plan to the Primary Care Physician, member and others in the Health Home. • Revises the Care Plan as needed and at a minimum following hospitalization of the member or following the annual re-assessment. • Meets with patients face to face in the home or at physician appointments to complete assessments and other contacts, as necessary. • With the support of the Care Team,  re-engages the member following hospital admissions and emergency room use through reassessment, coordination of transition of care, including PCP appointment and transportation as needed. • Monitors the appropriate use of outpatient ancillary services, medication adherence, compliance to PCP visit schedules and results of lab work. • Provides Transition of Care follow-up visits or calls to patients following change in level of care. • Provides health education regarding disease process, medications, medication adherence, community resources and benefits. • Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. • Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. •  Maintains at least the minimum performance and productivity standards. • Completes a minimum of three recommended AIDS related in-services, trainings or conferences per year. o Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency • Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. • Advocates for member needs with medical provider, RN Care Team Manager and community. • Reports all complaints and grievances per grievance policy. • Other duties as assigned to ensure team goals are met. Management Responsibilities Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Supervises and delegates appropriate tasks to the LPN Care Partner, the Care Coordinator and the Social Worker and monitors for the appropriate completion of assigned tasks. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management on member clinical, satisfaction, utilization and cost issues. Signs off on Care Plans developed by the LPN Care Partner.   Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN Program. BSN preferred.  At least five years clinical experience and three years Case Management, Community nursing, Home Health or Hospice nursing desired Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification within two years of employment. Certified in AIDS Care or eligible for ANAC certification within three years of employment.   Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.  Language Skills Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues   Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing..  Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables.   Travel:  Over 50% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, and AHF office.  Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a leader or member  of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred  Certification in case management preferred  Current CPR (Cardio Pulmonary Resuscitation) Certificate Required Valid Florida Driver’s License with proof of automobile liability insurance   We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.
Aids Healthcare Foundation Jacksonville, FL , United States
Jan 05, 2018
Part time
Overview:     AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHF’s core values are: • Patient-Centered • Value Employees • Respect for Diversity • Nimble • Fight for What’s Right   STILL INTERESTED? Please continue! AHF is currently seeking a Part Time LPN in our Jacksonville clinic. The hours are Monday-Friday 8 am to 2 pm.   We offer a competitive salary and a great work environment.   Responsibilities: Essential Duties & Responsibilities Includes the following.  Other duties may be assigned.   Documents patient's weight, temperature, pulse, respiration and blood pressure at patient healthcare visit as ordered or per protocol. Collects other pertinent patient information as defined by Department of Medicine—eg:, Depression Screening ; Tuberculosis screening; presenting chief complaint Collects samples such as urine, blood, and stool specimens in the Healthcare Centers as ordered and instructs patients in home collection of urine, stool and sputum specimens, when appropriate. Performs phlebotomy as ordered and prepares specimens for transport to laboratory. Performs patient procedures as ordered including ear lavages; EKGs; dressing changes; injections and documents appropriate information in patient’s EMR. Documents services performed for compliance and reporting purposes. Reviews physician orders, lab requests or follow-up needs with patient. Collaborates with other nursing personnel and participates as a team member.  May receive laboratory results over the telephone and transmit them to the Nurse Manager and the patient's medical provider in a timely manner. Administers Purified Protein Derivative (PPD), as ordered.  Documents in patient’s EMR and completes associated County required documents and scans and sends to County. Administers controlled medication and documents appropriately in EMR. Reports changes in patient's physical status to the Nurse Manager or medical provider. Assists physician with examinations and procedures as assigned. Documents observations as requested by an MD, PA , NP and/or Nurse Manager in the patient's medical record. Receives and processes medication refill requests; verifies medication requests with healthcare provider and obtains appropriate documentation. Ensures maintenance of patient confidentiality. Maintains supplies and cleanliness of examination rooms. Maintains logs as directed by the Nurse Manager. Maintains standard precautions for infection control. Able to travel to other HealthCare Centers as needed for cross-covering staffing requirements.   Participation in AHF Meetings/Committees Attends AHF meetings as assigned.   Supervisory Responsibilities This job has no supervisory responsibilities.   Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience High school diploma or general education degree (GED);  graduate of an accredited licensed vocational nurse program.  Minimum of two years related experience and/or training.   Computer/Software Skills & Abilities Proficiency in word processing and basic data base programs. Proficiency in Logician/EMR (training and continuing education will be provided in house).   Language Skills Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.     Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent to draw and interpret bar graphs.     Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.   Other Skills & Abilities/Qualifications Communicates in a tactful and professional manner. Bilingual (English/Spanish) highly desirable. Experience and sensitivity in working with individuals affected by HIV/AIDS. Ability to work to travel to multiple healthcare centers for cross-covering staffing requirements preferred. Certificates, Licenses and Registrations Valid Florida LPN License, without restrictions. Valid C.P.R. certification. Certificate in phlebotomy and intravenous (IV) therapy; certification must be presented upon hire or prior to the completion of the initial 90-day introductory period. Current Driver’s license and proof of liability insurance.
Aids Healthcare Foundation Miami, FL , United States
Jan 05, 2018
Full time
Overview: PHC/PHP is currently seeking an RN Care Team Manager for Miami Dade county (South).    We offer a competitive salary, amazing benefts and a great work environment. A bilingual candidate is preferred but not required to apply. Travel to Monroe County 1-2 times a month or as needed will be required to address member needs.   Summary The RN Care Team Manager is responsible for projecting and integrating the Mission and Core Values of the organization in the provision care management services to members of the AHF/AHFMCO Medicare and Medicaid health plans of Florida. Key responsibilities include leading the care team which provides culturally and linguistically sensitive care management services to the HIV/AIDS special needs population enrolled in the Medicare and Medicaid health plans under the supervision of the RN Care Team Manager, participating in the gathering and transmission of information and data to the RN Care Team Manager for assessment and care planning, participating in interdisciplinary team meetings, participation in activities that increase understanding of the communities served by the AHF/AHF MCO and going the extra mile to assure members have access and knowledge of their health plan benefits, community benefits,  treatment plan, and  medication adherence.      Responsibilities:   Essential Duties & Responsibilities Duties and Responsibilities include but are not limited to: • Collaborates with and plays a lead role with Health Care Center and external network PCPs, the Care Team and other practitioners to ensure members are well supported and managed within the Health Home of the Chronic Care Model. • Collaborates with ASO's, PAC Providers and other Community Services as necessary to ensure appropriate access to service and follow up on the results to such referrals. • Responsible to manage and coordinate care for an assigned population of Level 3, high risk members. • Orients new members to the Managed Care program through Welcome and Transition calls. • Completes assessments and re-assessments timely for members assigned to the Care Team. • With the member, establishes patient centered long term and short term goals for care and self management. • With the input of the member, family and medical team, creates an appropriate and timely individual care plan to assist the member to achieve the established goals. • Maintains current knowledge of MCO benefit structure, policies and procedures related to authorization of services. And is adept at creating a wrap around solution to address member’s needs using appropriate MCO benefits and available ASO and community resources. • Works to deliver care management services in an efficient and cost effective manner. • Performs PAC assessments and exception request visits as requested  • Adheres to PAC Manual when delivering PAC assessment or reassessment services.  • Communicates the care plan to the Primary Care Physician, member and others in the Health Home. • Revises the Care Plan as needed and at a minimum following hospitalization of the member or following the annual re-assessment. • Meets with patients face to face in the home or at physician appointments to complete assessments and other contacts, as necessary. • With the support of the Care Team,  re-engages the member following hospital admissions and emergency room use through reassessment, coordination of transition of care, including PCP appointment and transportation as needed. • Monitors the appropriate use of outpatient ancillary services, medication adherence, compliance to PCP visit schedules and results of lab work. • Provides Transition of Care follow-up visits or calls to patients following change in level of care. • Provides health education regarding disease process, medications, medication adherence, community resources and benefits. • Collaborates with AIDS Service Organizations and other community resources, as necessary, to ensure appropriate access to care and services. • Maintains current clinical knowledge of HIV/AIDS medications and treatment regimens. •  Maintains at least the minimum performance and productivity standards. • Completes a minimum of three recommended AIDS related in-services, trainings or conferences per year. o Obtains and maintains HIV/AIDS disease/treatment general knowledge proficiency • Reports urgent member issues and barriers to care to the Primary Care Provider and the Director of UM/CM, as appropriate. • Advocates for member needs with medical provider, RN Care Team Manager and community. • Reports all complaints and grievances per grievance policy. • Other duties as assigned to ensure team goals are met. Management Responsibilities Collaborates with the Director of UM/CM or their designee on the day to day supervision of the Care Team members. Supervises and delegates appropriate tasks to the LPN Care Partner, the Care Coordinator and the Social Worker and monitors for the appropriate completion of assigned tasks. Organizes and leads the team conferences with the Interdisciplinary Team. Collaborates with the Plan Medical Director, Manager and Director of Utilization and Case Management on member clinical, satisfaction, utilization and cost issues. Signs off on Care Plans developed by the LPN Care Partner.   Qualifications: Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Education and/or Experience Graduate from an accredited RN Program. BSN preferred.  At least five years clinical experience and three years Case Management, Community nursing, Home Health or Hospice nursing desired Managed Care experience a plus with knowledge of Medicare and Florida Medicaid regulations Certified Case Manager (CCM) or eligible for certification within two years of employment. Certified in AIDS Care or eligible for ANAC certification within three years of employment.   Computer/Software Skills & Abilities To perform this job successfully, an individual should have adequate typing skills and basic knowledge of business software, including but not limited to: MS Word  MS Excel, MS Access data base input to pre-designed forms, Internet Explorer and MS Outlook.  Knowledge of MS Visio a plus.  Language Skills Excellent written and verbal communication skills. Ability to read, analyze, and interpret AHF/AHF MCO documents, policies, procedures, publications, and other documents. Ability to respond effectively to sensitive inquiries or issues   Skilled in motivational interviewing techniques to engage member in the plan of care Ability to effectively present information and respond to questions from groups of peers, superiors, clients, customers, and the general public. Bilingual Spanish, and/or  Creole a plus. Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions. and express same verbally and/or in writing..  Ability to interpret and follow a flow diagram. Ability to apply the nursing process to assessment, care planning and patient management. Ability to prioritize tasks and delegate to the appropriate staff  Ability to interpret a variety of technical instructions in mathematical or diagram format including abstract and concrete variables.   Travel:  Over 50% Local travel. Home/ field based position with daily local travel to Health Care Centers, inpatient facilities, physician offices, patient homes, and AHF office.  Other Skills & Abilities/Qualifications Excellent organizational skills. Ability to successfully work with various levels of professional and non-professional staff. Must be able to work independently and as a leader or member  of a team. Knowledge of HIV/AIDS, related medical and patient care issues and concerns in diverse populations Certificates, Licenses and Registrations Unrestricted Registered Nurse licensed by the State of Florida Baccalaureate Degree preferred  Certification in case management preferred  Current CPR (Cardio Pulmonary Resuscitation) Certificate Required Valid Florida Driver’s License with proof of automobile liability insurance   We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability.  The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.