MMA Care Manager
Independent Living Systems, LLC
full-time
Posted on:
Location Type: Office
Location: Miami • Florida • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Conduct thorough assessments of members’ health status, medical history, and social determinants of health to develop personalized care plans.
- Coordinate with physicians, specialists, and other healthcare professionals to ensure timely and effective delivery of medical services.
- Monitor member adherence to prescribed treatments and medications, providing education and support to encourage compliance.
- Identify and address potential gaps in care, including arranging for additional services such as home health, rehabilitation, or community resources.
- Maintain detailed documentation of care plans, member interactions, and outcomes in compliance with regulatory and organizational standards.
Requirements
- Bachelor’s degree in Nursing, Social Work, Public Health, or a related healthcare field.
- Current and valid professional licensure or certification relevant to care management (e.g., RN, LCSW).
- Minimum of 3 years’ experience in case management, care coordination, or a related healthcare role.
- Strong knowledge of Medicare Advantage programs, healthcare regulations, and care management best practices.
- Proficiency in electronic health records (EHR) systems and care management software.
- Relevant experience may substitute for the educational requirement on a year-for-year basis.
- Master’s degree in Nursing, Social Work, Public Health, or a related healthcare field (preferred).
- Certified Case Manager (CCM) or Accredited Case Manager (ACM) certification (preferred).
- Experience working specifically with Medicare Advantage populations (preferred).
- Advanced degree in healthcare administration, nursing, or social work (preferred).
- Familiarity with population health management and quality improvement methodologies (preferred).
- Bilingual abilities to effectively communicate with diverse member populations (preferred).
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
case managementcare coordinationhealth assessmentspersonalized care plansMedicare Advantage programshealthcare regulationspopulation health managementquality improvement methodologieselectronic health records (EHR)care management software
Soft skills
communicationeducationsupportorganizationcollaborationproblem-solvingadherence monitoringdocumentationinterpersonal skillscultural competency
Certifications
Registered Nurse (RN)Licensed Clinical Social Worker (LCSW)Certified Case Manager (CCM)Accredited Case Manager (ACM)