The PMHNP will play a crucial role in expanding access to mental health care, particularly in underserved areas within a consulting medical firm. This individual will be responsible for providing strategic direction, potentially managing a team of clinical professionals, and ensuring that high-quality, patient-centered care is delivered. The PMHNP will work closely with healthcare providers, clients, and stakeholders to develop and implement effective care management strategies that optimize patient outcomes while aligning with organizational goals and regulatory requirements.
RESPONSIBILITIES & COMPETENCIES
Admission to and discharge from care management services. Utilization of the case management process to guide service delivery. Facilitation of the development of individualized plans of care including desired outcomes. Coordination of services and support required to facilitate a plan of care implementation and satisfy contractual/regulatory requirements. Monitoring ongoing services, and cost-effectiveness and recommending changes to the plan as needed. Evaluation of desired and actual outcomes. Facilitation of cost-effective alternatives to care. Recommendation of cost-effective alternatives to care provision. Being a resource to community service providers. Maintains care management records. Maintains communication with other members of the health care team. Delivering services utilizing virtual and some on-site visitation as well as convening and attending multidisciplinary team meetings, and maintaining periodic, regular contact with recipients of service and other members of the health care team. Provide guidance and education to families about managing behaviors and emotions. Monitor client satisfaction and resolve any issues or concerns related to services. Ensure compliance with relevant healthcare regulations, standards, and quality benchmarks, including HIPAA, accreditation requirements, and client-specific guidelines. Implement processes to track patient outcomes, satisfaction, and service delivery metrics, providing regular reports to senior leadership and clients. Identify areas for process improvement and lead quality improvement initiatives within the team. Analyze data related to patient outcomes, utilization, and care management performance to provide actionable insights to internal teams and clients. Generate reports and conduct presentations to senior management, clients, and stakeholders on clinical care management performance and improvement efforts. Work closely with other departments such as medical, operational, and IT teams to ensure integrated and efficient processes. Coordinate with external healthcare providers, specialists, and vendors to ensure continuity of care and optimal treatment outcomes for patients. Oversee and manage the care management departments budget and resource allocation, ensuring cost-effective delivery of services. Identify and implement strategies to reduce costs while maintaining high standards of patient care. Stay up-to-date with industry trends, emerging clinical best practices, and regulatory changes. Drive innovation and continuous improvement initiatives within the clinical care management function.QUALIFICATIONS
Bachelor of Science degree in nursing preferred, and PMHNP Licensure in MD required. Graduated from an accredited college or university or possess equivalent education and experience. CCM certification is preferred and is required within two years of the date of employment at Medicalincs. Minimum of three years' experience in one or more of the following areas: - Pediatric intensive care nursing - ambulatory health or - rehabilitation nursing - clinical social work practice in a community setting with individuals with complex health care needs. Demonstrate high clinical competence, and ability to work in a team situation with other professionals and can carry out responsibilities with minimal supervision. Proof of current state licensure andcurrent malpractice insurance coverage is required;insurance should be always maintained. Proof of current automobile insurance is required. Ability to travel throughout Maryland with reliable transportation and a valid drivers license with a record in good standing. Designated home office space that must satisfy all HIPAA requirements. Excellent organizational, prioritization, and interpersonal skills. Must be able to Telework from Home Based Office. Must have high-speed Internet connection and familiarity with Microsoft Office Suite (Word, Excel, Access, and Outlook), databases, and using tools to communicate remotely and document client information. In addition to the above qualifications the successful incumbent is expected to consistently demonstrate: A positive working attitude that supports the needs of the care management team Support of the mission and values of Medicalincs and a commitment to a person-centered, family-centered, culturally competent philosophical base Commitment to continuous quality improvement working with co-workers in a team-oriented collaborative governance model Flexibility and the ability to adapt to the changing healthcare environment and legislationREQUIREMENTS
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.
While performing the duties of this job, the employee is regularly required to talk or listen. The employee is regularly required to stand, walk, sit; use hands to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. The employee is required to complete onsite visits with clients by driving to their homes, schools, physician offices, and other healthcare facilities. The employee is required to document client-related activities and conversations on their laptop in our client database within 48 hours of the client interaction.
OTHER DUTIES
Please note this job description is not designed to cover or contain a comprehensive listing of activates, duties, or responsibilities that are required of the employee for this job.
ABOUT MEDICALINCS
Medicalincs (Medicalincs) is a renowned healthcare business & clinical management services firm that supports health organizations to improve organizational performance by providing less expensive, human-centered, integrated, managed care solutions. We have significantly improved health outcomes, cost savings, and return on investment for our clients.
Founded in 2013 and launched in 2017, we are located at Silver Spring, Maryland, and serve the Maryland, District of Columbia, and Virginia regions.
OUR MISSION: At Medicalincs, our mission is to link silos in the healthcare system -- to achieve the most cost-effective, high quality, and continually-improved care delivery that preserves & saves lives!
OUR PHILOSOPHY:To make a difference, you need to be THICK - Trusted, Hearty, Innovative, Committed, & Kaizen!
Medicalincs brings a unique understanding of healthcare delivery systems across healthcare settings & payer groups;and in-depth experience applying strategic fusion of clinical, business, and technical expertise -- to drive comprehensiveand tried-and-true lasting solutions to advance networks and population health management. Our areas of expertiseinclude: Managed Care & Care Value | Care Delivery Model Transformation Implementation | Quality Improvement &Patient Safety | Program Management & Change Management | Program Evaluation & Data Analytics |Organizational Development & Strategic Planning.
Medicalincs takes a rigorous approach to recruiting talent to our company that balances equal parts role-specificcompetencies and cultural fit. Our process ensures that we can provide the right professional, with the proper expertise, toeach and every one of our clients. As experts in the management space, we believe effective service delivery should be therule, not the exception. Far from being a one-size-fits-all solutions provider, we provide right-sized management support,tailored to best fit the needs of our clients. With a results-driven focus, we listen to our clients and work to help them meettheir specific program and organizational goals.
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