GONZABA MEDICAL GROUP Jobs (5)

Description

The Hospital Case Manager (HCM) focuses on concurrent review of GMG MC patients (members) in the hospital and facility setting.

Utilizing nationally recognized care guidelines and the patient’s health plan coverage guidelines, the HCM monitors admissions and continued stays for Medical appropriateness.

The HCM develops a discharge (DC) plan in coordination with the physician(s), the patient and the family to promote a safe and timely discharge.

They act as an advocate for members and their families by linking them to educational resources and community resources to support their aftercare.

Effective utilization management of healthcare resources is a major function of this role.The HCM participates in the Patient Care Committee Meeting (PCC) and other GMG or Case Management (CM) team meetings to optimize care plans, treatment plans and GMG protocols.

DUTIES :

• Round daily on assigned GMG MC Patients in the hospital setting, and at least weekly on those in the SNF setting.
• Utilize nationally recognized care guidelines and the patient’s health plan coverage guidelines to monitor admissions and continued stays for Medical appropriateness.
• Assess the medical, physical, psycho-social and transition needs to anticipate the services, equipment, and follow up care that will be needed upon DC.
• Confer with physician(s), patient, and families in developing the transitional or DC plan.
• Demonstrate knowledge of utilization management, care coordination, and current standards of care as a foundation for transition planning activities.
• Enter timely and accurate information into the EMR to document pertinent patient / family communications, referral authorizations and plans.
• Collaborate effectively with other members of the GMG CM team to clearly communicate regarding coverage determinations, authorizations, and any special follow up needed post DC.
• Communicate regularly with the MC Medical Director on patient status, issues or questions.
• Serve as the clinical liaison with hospital, clinical and administrative staff. Provide information on the clinical authorizations for inpatient / SNF care and milestones achieved toward DC status.
• Attend weekly Patient Care Committee (PCC) as census allows.
• Provide constructive information to patients and families to minimize problems and increase customer satisfaction. Explain and reinforce the physician plan of care.
• Decision-making is usually based on prior practice or policy, with some interpretation. Must apply individual reasoning to the solution of problems.
• Maintain current knowledge of health plan benefits, health plan contracts and preferred provider network.
• With the assistance of other members of the GMG MC teams, guides physicians in their awareness of preferred contracts, providers and facilities.
• Perform Clinical High Risk Home Visits as assigned.
• Maintains strict confidentiality of all PHI; Protects laptop, cell phone, and documents.
• Performs all other related duties as assigned.

EDUCATION, EXPERIENCE & SKILLS :

• Education required : Bachelor’s or Associate’s degree in Nursing
• Current, unrestricted RN license required.
• Four or more years of diverse clinical experience in caring for the acutely ill patients with multiple disease conditions in adult and geriatric populations.
• Two or more years of managed care and / or case management experience preferred.
• Able to communicate clearly in both written and verbal format. Strong interpersonal skills.
• Strong organization, planning and decision making skills. Able to think independently to identify problems and define action plan to resolve.
• Proficient with Microsoft Office applications including Word, and Excel.
• Case Management Certification (CCM) preferred.

PREFERRED Language SKILLS :

Bilingual (English / Spanish) language proficiency.

Supervisory Responsibilities :

This job has no supervisory responsibilities.

Work Environment : Depending upon the area assigned, may be 100% clinical setting, office setting in a clinical environment : Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinic environment.

Physical Demands : Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 40 lbs.

Close vision and ability to adjust focus.

Qualifications

Skills

Behaviors

Motivations

Education

Preferred

Bachelors or better in Nursing.

Experience

Licenses & Certifications

Required

Registered Nurse

Description

Provide varied social work (SW) services to managed care patients and their families.Aid in development of treatment plans, patient discharge needs, and provide social, emotional and mental assessments on patients.

Act as an advocate for members and their families linking them to educational resource and community resources to support their healthcare.

SW participates in GMG High Risk meeting or Case Management (CM) team meeting to optimize care plane, treatment plans and GMG protocols.

Serves as a resource to the care team.

Essential Functions :

• Serve as a strong resource to GMG physicians, clinical staff and CM staff regarding community services, resources, and facilities to best serve the patients.
• Demonstrate knowledge of utilization management, care coordination, and current standards of care as a foundation for assessment and planning activities.
• Assess the medical, physical, psycho-social and transition needs of patients and families in various settings (hospital, SNF, home, clinic, etc.

to create individualized transitional and social plans.

• Conduct periodic reassessments and adjust plans accordingly.
• Communicate effectively with patients and families to optimize the plan of care, increase customer satisfaction and minimize misunderstandings.
• Confer with physician(s), case manager, and other pertinent sources to gather and provide information to the care team.
• Communicate with the MC Medical Director as indicated on pertinent patients to discuss patient status, issues, questions.

8.Document pertinent patient / family communications, referral authorizations and plans into the EMR in a timely manner.

9.Document appropriately in complex care database and other associated work-related systems.

10.Maintain current knowledge of health plan benefits, health plan contracts and preferred provider network.

11.Assume responsibility for personal and professional development and maintenance of skills in social work

12.Exercise tact and courtesy when dealing with patients, visitors, physicians and co-workers.

• Demonstrate effective decision-making and individual reasoning to the solution of problems.
• Attend and participate in assigned meetings.

15.Maintains strictest member and company confidentiality; Ensures member health information is secured each day.

16.Able to work efficiently under pressure.

17.Perform other duties as assigned.

Computer Skills :

Strong computer skills required; Experience with Electronic Medical Records (EMR) Basic knowledge of MS Word, Excel, Outlook, and Internet software

Supervisory Responsibilities :

This job has no supervisory responsibilities

Education, Job Experience, and Skills :

• Must have degree in social work (BSW) from an accredited program.
• Two or more years of managed care experience .
• At least 3 years of diverse clinical experience in caring for the acutely ill patients with multiple disease conditions in adult and geriatric populations.

4.Able to communicate clearly in both written and verbal format.Strong interpersonal skills.

PREFERRED Language SKILLS :

Bilingual (English / Spanish) language proficiency required.

Work Environment :

Depending upon the area assigned, may be 100% clinical setting or office setting in a clinical environment, Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinic, hospital, skilled nursing facility, or patient home environment.

Faced paced setting, with the ability to work nights, weekends and holidays as required; May take after hours phone calls

Physical Requirements :

Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 40 lbs.

Close vision and ability to adjust focus.

The above job description is not intended to be an all-inclusive list of duties and standards of the position.Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions of the job.

Qualifications

Skills

Behaviors

Motivations

Education

Required

Bachelors or better in Social Work.

Experience

Licenses & Certifications

Preferred

CPR Certification

Social Worker

Description

Summary :

The Executive Assistant will be responsible for managing the day-to-day operations of the Executive Office while serving as primary liaison to internal and external contacts on behalf of the CEO.

Functions as an extension of the CEO by anticipating needs and proactively addressing issues with an emphasis on sound judgment, initiative, and confidentiality, with appropriate but minimal direction.

This position facilitates efficient execution of the CEO’s daily responsibilities by vetting internal and external requests, directing assignments to appropriate staff, working closely with the CEO’s direct report team.

The Executive Assistant will manage internal and external correspondence, monitor the Executive Office, spearhead special projects for the CEO, prepare and manage special events.

Liaison must be able to interface successfully with internal departments and external contacts using diplomacy and discretion.

The Executive serves as the CEO’s ambassador in dealing with key external contacts, executive members, and other leaders of the organization.

Duties :

• Communicates the CEO’s directives by coordinating and overseeing workflow in a fast-paced, rapidly changing work environment.
• Disseminates pertinent information to staff on behalf of the CEO.
• Advises the CEO on organizational and departmental priorities as appropriate and drives and supports necessary content preparation.
• Provides oversight of the preparation of all materials for the CEO’s schedule including travel, speeches, presentations, correspondence, and other administrative functions.
• Serves as the liaison and gatekeeper to Executive team, Management team and staff seeking contact with the CEO’s office, ensuring timely and appropriate management of all inquiries that come to the CEO’s office.
• Monitors internal and external deadlines and action items for the CEO and provides appropriate reminders.
• Judiciously manages the CEO’s demanding schedule.
• Coordinates mailings and drafts correspondence from the CEO.
• Manages special projects, including but not limited to special events, meetings, and other tasks as requested by the CEO.
• Communicates regularly with members of the Executive team on behalf of the CEO.
• Provides strategic input into the planning of all Executive committee and Leadership meetings based on the priorities and requests of the CEO.
• Works with the CEO to develop the meeting agendas and content, and to identify the specific action / follow-up items from each such meeting;

may also be required to provide oversight of the development and distribution of the minutes from these meetings.

Education and Experience :

Bachelor’s degree : Masters is preferred. Strong work tenure : three to five years of experience working in direct support and advisory role of a senior leader in management, operations, or communications.

Familiarity with healthcare and management. Experience in working with leadership team. Expert proficiency in Microsoft Office (Outlook, Word, Excel) including experience management of a CEO’s electronic calendar and inbox.

Knowledge, Skills, and Abilities :

A trusted advisor to the CEO. Proven ability to multi-task and prioritize responsibilities in fast-paced work environment.

Excellent attention to details and conscientious in adhering to deadlines and deliverables. An independent thinker who can bring the maturity, initiative, creativity, energy, discipline, and commitment needed to support the CEO and collaborate with the Executive Team.

A high-level performer with the ability to be proactive and respond rapidly to changing conditions in a fast-paced environment.

Highly collaborative with an appreciation of the benefit of a multi-disciplinary team approach; demonstrated ability to work with and function as part of a team.

Strong organizational and creative problem-solving skills are necessary. Strong oral and written communication skills; experience using social media for business or professional purposes.

Skilled at dealing with internal and external partners both respectfully and professionally and with diplomacy and tact.

Ability to work flexible hours, including evenings and weekends as needed. Highly discrete and able to be trusted with confidential information relating to the organization and its staff.

Personable, productive, organized and customer-focused with a positive attitude.

Work Environment : Depending upon the area assigned, may be 100% clinical setting or office setting in a clinical environment.

Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations, and other conditions common to a clinic environment.

On-site work outside. Works in conditions of heat, cold, wet, dust, rain. Occasional evening or weekend work.

Physical Demands : Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 40 lbs.

Close vision and ability to adjust focus.

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions of the job.

Qualifications

Skills

Behaviors

Motivations

Education

Experience

Licenses & Certifications

Description

Summary : The Community Healthcare Coordinator reports directly to the Community Healthcare Manager and works collaboratively and effectively to develop and execute marketing field strategies and plans to help positively drive enrollment in Medicare Advantage programs.

The Community Healthcare Coordinator operates efficiently and effectively in a deadline-driven environment and provides day-to-day support and execution for field marketing activities.

The Community Healthcare Coordinator is engaged and productive as part of the Marketing Team and demonstrates self-motivation and energy in ensuring all strategies, deadlines, brand alignment, and budgetary goals are successfully achieved.

Additionally, the Field Marketing Coordinator helps the field marketing team with marketing applications, reporting, outbound telemarketing calls, and the maintenance of marketing databases.

The Community Healthcare Coordinator works collaboratively with all GMG Marketing leaders, agents and / or brokers and vendors to coordinate effective and successful marketing activities.

Job Functions and Responsibilities :

• Work collaboratively across all marketing functions to achieve Field Marketing Team goals and to support growth of patient prospects and Managed Care enrollments.
• Work closely with the Field Marketing Team to support such activities as, but not limited to : event coordination, data entry, printing, scanning, answering phones, general office duties, etc.
• Work closely with the Field Marketing Team to support distribution of fliers, mail pieces, posters, and all marketing / promotional activities
• Work closely with the Field Marketing Team to support various in-house events or community events including, but not limited to : event coordination, purchasing event supplies, participating in events, etc.
• Maintain and update marketing databases, including data entry and report generation.
• Provide follow-up and sale generation through outbound telemarketing calls as needed.
• Support all company initiatives, give actionable feedback, share best practices and serve as an advocate and information source for the company
• Maintain consistent communication with Marketing Team members and Director of Marketing on all matters related to business
• Develop understanding of product line and value chain
• Develop and maintain supportive, productive and effective relationships at all levels within the organization
• Maintain efficient time management skills to ensure maximum customer contact and highest level of customer service
• Participate in promotional activities, trade shows and health fairs to market products and services
• Provide new ideas for streamlining our marketing activities
• Provide support for promotional events, including evenings and weekends
• Maintain strict confidentiality
• Other duties as assigned

Job Requirements : Must have excellent written and verbal communication skills. Knowledge and experience with field marketing techniques and practices.

Qualifications :

• 1-2 years’ experience in marketing, or previous experience in a similar role preferred
• General computer knowledge of Microsoft office / Outlook and Customer Relationship Management (CRM) tools.
• A demonstrated ability to communicate effectively and work well with sales management
• A demonstrated history of successfully achieving goals, objectives and high performance.
• Ability to work independently and collaboratively within a team
• Must be adept at handling pressure and working under stress

Work Environment : Depending upon the area assigned, may be 100% clinical setting or office setting in a clinical environment.

Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinic environment.

On-site work outside. Works in conditions of heat, cold, wet, dust, rain. Occasional evening or weekend work.

Physical Demands : Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 60 lbs.

Close vision and ability to adjust focus.

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions of the job.

Qualifications

Skills

Behaviors

Motivations

Education

Experience

Licenses & Certifications

General Summary : An exempt position responsible for providing services and assisting Gonzaba Medical Group’s General Surgeon / Colorectal Surgeon, including assessing, diagnosing, prescribing, treating, and educating patients.

Works closely with physicians and other clinicians in a team approach to patient care. May specialize in a specific type of clinical care, e.g., well women.

Essential Job Responsibilities :

Assesses patient status by obtaining health history through patient / family interviews and chart reviews; assessing presenting illness, risk factors, and family history, psychosocial situation, and cultural factors;

and performing appropriate physical examination.

Orders / performs appropriate laboratory diagnostic and other screening tests. Seeks other information as needed, including consultation with physicians and other clinicians, for evaluation of illness.

Integrates data to determine diagnosis and therapeutic plan, including identification of any health risks.

Develops and implements treatment plan by prescribing / dispensing medications and / or injections in compliance with medical practice guidelines and state laws.

Handles minor lacerations. Instructs patient / family regarding medications and treatments. Educates patients regarding health promotion / illness prevention.

Recommends appropriate community resources to meet patient / family needs. Communicates appropriate case management information to other professionals and community agencies.

Prepares documentation for medical records including updating patient medical chart by posting examination and test results, diagnosis, medications, and treatment in written / computerized manner.

Participates in peer reviews, chart reviews, staff education, clinical guideline development, and other continuing education and quality assurance activities to demonstrate compliance with standards, regulations, policies, and procedures.

Acts as consultant / collaborator to clinical team on area of specialty. Complies with patient confidentiality requirements.

Promotes patient advocacy.

• Collaborates with physicians in managing acute and long-term medical needs of patient. Provides monitoring and continuity of care between visits according to treatment plan including triaging patient calls / e-mails.
• Performing surgeries alongside the Colorectal Surgeon in clinic and hospital (inpatient and outpatient)

Education : Graduate of an approved physician assistant program with a either BS, MS preferred.

Other Requirements : Current state license. Current CPR certification.

Performance Requirements :

Knowledge :

• Knowledge of anatomy and physiology, pathophysiology, pharmacology and therapeutics, basic nutrition, behavioral factors, psychosocial / family systems, diagnostic testing, interpretation of results and clinical decision making, alternative treatment modalities.
• Knowledge of surgical experience or has had training courses in surgical follow ups
• Knowledge of professional theory, practices and regulations related to evaluating and providing patient care, and professional ethics related to the delivery of nursing care.
• Knowledge of medical equipment and instruments used to administer patient care.
• Knowledge of common safety hazards and precautions to establish / maintain a safe work environment.
• Knowledge of health promotion, health risk identification, and patient education principles and techniques.
• Knowledge of community, professional, and educational resources.

Skills :

Skill in oral and written communication including interviewing to gather medical histories, providing presentations, consultations, facilitation, and documentation, e.

g., writing medical orders, patient education materials, and medical record updates. May require skill in using computerized health information management systems.

• Skill in case management, time management, problem solving, crisis intervention, multitasking, and other organizational matters.
• Skill in modifying methods and techniques of professional nursing to provide appropriate nursing care and in initiating appropriate emergency response and investigatory procedures.

Abilities :

• Ability to analyze complex data and draw conclusions.
• Ability to interpret, adapt, and apply guidelines and procedures.
• Ability to establish / maintain effective working relationships with patients, clinical staff, and the public.
• Ability to complete clinical rounds in local hospitals
• Ability to have open availability on weekdays, weekends, and an on-call schedule

Equipment Operated : Standard medical examination room equipment and instruments. May include use of computer / health information management system.

Work Environment : Combination of exam rooms and medical offices. Frequent exposure to communicable diseases, toxic substances, ionizing radiation, medicinal preparations, and other conditions common to a clinic environment.

Mental / Physical Requirements : Requires standing and walking for extensive periods of time. Occasionally requires lifting and carrying items weighing up to 10 pounds.

Requires correct vision and hearing to normal range. Requires working under stress in emergency situations and occasionally may involve irregular working hours.

Employee Exposure Determination : Category I : Jobs with tasks that routinely involve exposure or potential exposure to blood, body fluids or tissues.

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions of the job.