AIDS Healthcare Foundation

  • RN Care Team Manager

    Job Locations US-GA-Atlanta
    Job Post Information* : Posted Date 6 months ago(5/7/2018 7:39 PM)
    Req No
    2018-7462
    Category
    Managed Care
  • Overview

    Positive Healthcare, AIDS Healthcare Foundation's Managed Care Division, has provided people living with HIV quality health care since 1995 when it started the nation’s first Medicaid health plan for HIV-positive people living in Los Angeles. Today, Positive Healthcare cares for more than 7,000 lives in California and Florida.

     
    PHP (HMO SNP)
    PHP is a Medicare Advantage Prescription Drug health plan specifically for Medicare beneficiaries who are living with HIV and reside in Duval, Broward and Miami-Dade Counties.
    PHP is the first HIV-specific special needs health plan approved by the Centers for Medicare & Medicaid Services (CMS). This plan covers routine doctor and specialist office visits, emergency and urgent care, hospitalization, and more. It also includes a prescription drug benefit for no monthly premium.
     
    PHC Florida
    PHC Florida is a Medicaid managed care plan designed specifically for HIV-positive individuals who are eligible for Medicaid and live in Broward, Miami-Dade and Monroe Counties.  PHC Florida is a Managed Medical Assitance (MMA) plan offered through Florida’s statewide Medicaid Managed Care Program 

     

     

    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!

     

    BENEFITS
    AHF offers comprehensive benefits to help our employees do and be their very best! These benefits are intended to enhance our employee’s physical, financial, spiritual, and professional wellbeing.

     

    Responsibilities

    The RN Care Team Manager (RNCTM) achieves AHF’s mission by demonstrating strong clinical skills, proactive thinking, and comprehensive knowledge of healthcare rules and supportive services with a special focus dedicated to HIV/AIDS members.

    By utilizing core principles of nursing, you will meet our members where they are, identify strengths and opportunities for growth and assist them with realistic goal setting. With skills of collaboration and engagement, you will work with our providers and interdisciplinary team to educate, reinforce, rehabilitate, and support our members to heal and grow to potentiate their health status and improve their quality of life.  Your input will directly contribute to the review for medical necessity, under and over utilization and as a result improve member’s health outcomes. 

     

    You, as the RNCTM, are the first line of support for both members and providers. You establish connections necessary to provide education so members may obtain realistic healthcare goals, services and objectives; collaborate with the member and PCP in developing personalized care plans which set specific interventions which impact the member’s health & wellbeing; educate members and providers regarding preventative wellness activities, incentives and resources; and promote achievement of mutually agreed upon goals maximizing their best clinical outcomes.

     

    By engaging in opportunities to increase knowledge of community, government, grant funded programs and health plan resources, the RNCTM can ensure the member optimizes all available health care resources. You also assist in improving member focused HEDIS measures, such as preventative wellness, which ensure our members keep healthy or Risk Adjustment which allows us to allocate services to members who are more at risk for poor health outcomes than other members.

    Enhance the experience of all Managed Care employees when you collaborate with other departments to ensure member needs are addressed. Improve relations with the AHF Healthcare Centers by integrating in the office and opening lines of communication between the member, health plan, and providers. 

     

    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.

     

    Qualifications

    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, 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

     

    Physical Demands

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

     

     

    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.

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed