Case & Disease Program Manager
Location Miami, Florida, United States of America Category Corporate Job Id R0017636
ChenMed is transforming healthcare for seniors. We provide big answers to big problems in health care delivery. ChenMed is a full-risk primary care market leader with an innovative philosophy, unique physician culture and end-to-end customized technology. These things allow us to provide world-class primary care and coordinated care to the most vulnerable population – moderate- to low-income seniors who have complex chronic diseases.
Through our innovative operating model, physician-led culture and empowering technology, we are able to drive key quality and cost outcomes that create value for patients, physicians and the overall health system. Our model allows us to practice medicine the way it should be practiced. By recruiting focused physicians and reducing their doctor-to-patient ratios, we increase patients’ “face time” during each monthly appointment and help foster stronger doctor-patient relationships. Our model also drives and enhances compliance with treatment plans.
As a result of our efforts, our patients realize lower hospital admissions. Their overwhelming response to our approach is reflected in our aggressive, organic growth and net promoter scores in the low to mid 90s, which is unheard of in any industry. Read more about our results and the value of the ChenMed model.
As a company, we are making a difference in the lives of seniors and the health care system overall.
ESSENTIAL JOB FUNCTIONS:
ChenMed is a multi-state physician-lead primary care organization specializing in value based care for seniors. We provide comprehensive case management services to our members, and are in the process of building a comprehensive disease management program.
The Case & Disease Program Manager is a leadership position that will assist in design of our case and disease management programs, and will be dedicated to effective implementation of our policies and procedures in each of our markets.
- This person will also monitor local compliance with our plans, assist with data management as it relates to our case and disease management activities, assist with self-audits and assist with preparation for external audits (for example, by health plans and national accrediting organizations)
- Primary Duties and Responsibilities:
- Work with market clinical and operations personnel to help establish care strategies for chronic diseases that are prevalent in the ChenMed/JenCare patient population.
- Assist with the planning and development, as well as implementation and direction of a program that provides services for chronic disease management.
- Coordinate a database of statistics and narratives for the identification, collection, and analysis of data for potential enrollment of members to the Disease Management program as well as tracking progress and efficacy of treatments and program outcomes.
- Create reports as required to reflect process and outcomes of chronic disease programs and present at appropriate committee(s).
- Insure compliance with CMS, NCQA and other accrediting bodies regulations. Assist with internal auditing and preparation for external auditing of case and disease management programs
- Coordinate and facilitate case management and chronic disease management committees
- Oversee chronic disease educational literature for patients and for staff.
- Assist with the development and market outreach to the community through lectures, health fairs, and other public events.
- Educate and train staff in new methods of approach for chronic disease management
- Ability to educate member as well as clinic personnel on the DM Program.
- Apply critical thinking skills and problem-solving techniques to the disease management process
- Partner with physicians for effective clinical management and utilization of resources for patient population.
- Provide clinical direction and coordination to the interdisciplinary team to formulate and implement a plan of care.
- Maintain current knowledge of disease processes, available resources, and treatment options appropriate to patient population.
- Consistently document all activities according to policy, including automated systems.
- Maintain ongoing communication of the action plan and timeline to the center for implementation.
- Act as a liaison for member as needed.
- As needed, provide direct patient care within the parameters of the case management and chronic disease management program
- Provides administrative coverage for Director of Case and Disease Management COE as needed.
- Consistently demonstrate excellent communication and interpersonal skills with supervisor, case manager, physicians, clinic staff, and corporate personnel. Identifies opportunities and readily participates in performance improvement activities
- Continuously demonstrates a positive attitude and understanding of case/disease management, supports team building, and is motivated to fulfill department objectives.<
- Knowledge and skill in the application of the techniques and practices of the nursing profession.
- Ability to understand and implement case and disease management philosophy and principles.
- Ability to explain medical instruction to members and their families.
- Ability to establish and maintain effective working relationships with Members and their families, Health Plans and local personnel.
- Ability to learn and understand appropriate Federal, State and local regulations
- Ability to interact and deal tactfully with the public
- Ability to read, speak and understand the English language fluently
- This position may require up to 25% of travel nationwide
At ChenMed, If you are an innovative, entrepreneurial minded, over-achiever who is extremely passionate in helping people and revolutionizing Healthcare again, we are that dynamic and exciting company you are looking for!
After applying, we encourage you to "follow" us on LinkedIn (ChenMed) as well! This way you can stay informed and up to date on what’s happening around our organization and start your path to becoming part of our FAMILY!
EDUCATION AND EXPERIENCE CRITERIA:
- RN Degree with experience in disease management required.
- Bachelor’s Degree in Nursing or RN with BA/BS in Healthcare related field preferred.
- Certification in Case Management is preferred.
- Minimum of five (5) years of case management or disease management.
- Computer skills required (MS Office, EMR)
ChenMed is a multi-state physician-lead primary care organization specializing in value based care for seniors. We provide comprehensive case management services to our members, and are in the process of building a comprehensive disease management program. The Case & Disease Management Program Manager is a new leadership position that will assist in design of our case and disease management programs, and will be dedicated to effective implementation of our policies and procedures in each of our markets. This person will also monitor local compliance with our plans, assist with data management as it relates to our case and disease management activities, assist with self-audits and assist with preparation for external audits (for example, by health plans and national accrediting organizations).
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Life at ChenMed
Meet Our Team
David Guerra MD, Medical Director