Tampa Case Management jobs?

I worked for years at Tampa General as a floor nurse and loved it. Welcome to the big time kinda place...best hospital culture around the area.

I have been doing HH case manage and am interviewing with UHC this week for a disease management position. They have a huge operation here in Tampa, as does Wellcare and Humana.

Coventry is a work comp company.

There are many case management positions and companies in the Tampa area
1. Blue Cross/Blue Shield (although I don't recommend this company)
2. United Healthcare
3. Baycare hospital systems
4. Coventry
5. Work comp case management companies

What is UHC? What does UHC stand for?

Where in Tampa are these companies located?

United Health Care Systems

Here is a Telephonic Case Management Position in Tampa, Florida:

General Summary:
GENERAL SUMMARY
Responsible for telephonically assessing, planning, implementing and coordinating all case management activities associated with an injured employee to evaluate the medical and disability needs of an injured worker and facilitate the patient’s appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel.

ESSENTIAL RESPONSIBILITIES
-- Works telephonically with workers’ compensation patients, employers, providers, and claims adjusters to coordinate and assure proper delivery and oversight of medical and disability services.
-- Performs pre-certification process for prescribed treatment by gathering relevant data and information through clinical interviews with the injured employee, provider(s), and the employer.
-- Evaluates and coordinates medical and rehabilitative services using cost containment strategies. Plans a proactive course of action to address issues presented to enhance the injured employee’s short- and long-term outcomes.
-- Assesses and identifies barriers to recovery; determines goals, objectives, and potential alternatives to care. Works as an advocate to promote the injured employee’s best interest, addressing treatment alternatives, coordination of quality, cost effective health care and rehabilitative services.
-- Assists the injured employee by providing medical and disability education and coordinating on-site job analysis, work conditioning, functional capacities, and ergonomic evaluations.
-- Negotiates and assists employers with the development of transitional sedentary or modified job duties based on the injured employee’s functional capacity to ensure the injured employee’s safe and timely return to work.
-- Monitors, evaluates, and documents case management activities and outcomes including, but not limited to, case management approaches, over or under utilization, inappropriate care, effective treatment, permanent or temporary loss of function, failed or premature return to work, and non-compliance.
-- Adheres to all appropriate privacy, security and confidentiality policies and procedures.
-- Performs other duties as assigned.


Learn More about Coventry Health Care

Job Requirements include:

JOB SPECIFICATIONS
RN with current state license required.
-- Previous (2 or more years) general clinical experience required.
-- Bachelor’s degree or equivalent experience preferred.
-- CCM, CRRN, COHN, or CDMS eligibility or current certification encouraged. These designations are required where dictated by state law.
-- Previous workers compensation, case management, utilization review or managed care experience preferred.
-- Strong problem solving and analytical skills.
-- Demonstrated communication, organizational, and interpersonal skills. This position is on-site for client/customer.
-- Must be computer proficient

We provide competitive salaries, excellent benefits and a desirable work environment.

Here is the United HC job posting

Telephonic RN Case Manager Opportunities-Tampa, FL




Job Description

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health. OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling.

By providing 60 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their health care needs, and enabling them to achieve their personal health and well-being goals.

As a Telephonic Case Manager, you will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. This may include case management, disease management, coordination of care and medical management consulting. You will also be responsible for providing health education, coaching and treatment decision support for members.
**Afternoon Shift 10am-9pm.

Primary responsibilities:

• Making outbound calls to assess members' current health status
• Identifying gaps or barriers in treatment plans
• Providing patient education to assist with self management
• Interacting with Medical Directors on challenging cases
• Coordinating care for members
• Making referrals to outside sources
• Coordinating services as needed (home health, DME, etc)
• Educating members on disease processes
• Encouraging members to make healthy lifestyle changes
• Documenting and tracking findings
• Utilizing Milliman criteria to determine if patients are in the correct hospital setting
• Making "welcome home" calls to ensure that discharged member receive the necessary services and resources

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.


Job Requirements

Qualifications:

• Current, unrestricted RN license in the State of FL
• 2+ years experience in a hospital setting, acute care, direct care experience OR experience as a telephonic Case Manager for another insurance company
• Computer proficiency including the ability to type and talk at the same time and to navigate a Windows environment
• Must live within a commutable distance of the Tampa, FL office

Additional Assets Preferred:

• BSN
• A Background in managed care
• Certified Case Manager (CCM)
• Cardiac experience preferred
• Experience /exposure with discharge planning
• Experience in utilization review, concurrent review and/or risk management
• Strong organizational skills and multitasking abilities will be keys to success