COMMUNITY HEALTH NURSING CONSULTANT - 64000664

Requisition No: 835113 

Agency: Department of Health

Working Title: COMMUNITY HEALTH NURSING CONSULTANT - 64000664

 Pay Plan: Career Service

Position Number: 64000664 

Salary:  $55,000 - $60,000 

Posting Closing Date: 11/11/2024 

Total Compensation Estimator Tool

FLORIDA DEPARTMENT OF HEALTH - OPEN COMPETITIVE OPPORTUNITY

Previous applicants will be considered and do not need to reapply.

Pending Position Description Approval and Update

 

This position is a responsible professional position that reports Director of Healthcare Quality and Clinical Management Unit for the Office of Children’s Medical Services Managed Care Plan. This position is responsible for promoting an integrated, comprehensive, and cost-effective health care system with a focus on health equity and social determinants of health to ensure access to quality care for CMS Plan enrollees. This incumbent will serve as the population health subject matter expert and will  perform independent and complex work. This role is responsible for coordinating resources, leading implementing projects, and day-to-day coordination, oversight, and monitoring for efficient operation of Population Health programs such as Medical Foster Care (MFC), Prenatal, Early and Periodic Screening, Diagnosis and Treatment Program gram of All-Inclusive Care for Children (PACC)/Partners in Care-Together for Families (PIC:TFK), and Early Intervention Services (EIS) programs. This incumbent will be a Community Health Nursing Consultant for related CMS Plan Program initiatives and activities which include but are not limited to Care Coordination/Case Management and Population Health.

 

Who we are:

Florida Department of Health Children’s Medical Services (CMS) Managed Care Plan is responsible for the program oversight of the CMS Health Plan. CMS Health Plan provides benefits for children up to age 21 who have chronic and serious health condition(s)

 

Your Specific Responsibilities:

• Providing on-going expertise, consultation, technical assistance and monitoring for the Population Health components of the CMS Managed Care Plan.   
• Collecting, analyzing, and reporting data pertaining to an integrated system of care which includes the PIC:TFK, MFC, EPSDT, EIS, prenatal population, and all population health programs. 
• Serving as the subject matter expert and the Plan’s liaison with the Agency for Health Care Administration and other program vendors for the PIC:TFK, MFC, EPSDT, EIS,  prenatal population and all population health programs and services.
• Participating, coordinating, and ensuring CMS Plan vendor representation for all staffing’s, workgroups, and meetings related to population health. Maintaining a tracking log and providing consultation and technical assistance on follow ups needed with the CMS Plan vendor. 
• Leading workgroup meetings and quality improvement projects for population health programs including but not limited to PIC:TFK, MFC, EPDST, EIS, and prenatal programs.
• Reviewing guidelines, statutes, and contract requirements related to all population health programs to provide technical assistance to providers, vendors, and partners.
• Performing programmatic clinical monitoring for the CMS Plan population health populations including but not limited to enrollee record reviews, report reviews, program reviews, and contract reviews.
• Maintaining electronic files with written instructions for each component of the job detailing who gets copied on emails, notifications, etc. File is updated if the instructions change and is reviewed quarterly for accuracy.
• Monitoring and leading initiatives for quality improvement projects in the area of population health.
• Assisting in investigation and resolution of member quality of care complaints when escalated to the CMS Managed Care Plan Central Office for clinical reasons related to population health and keeps detailed records of each.
• Providing technical assistance to contract vendors to meet reporting requirements with defined timeframes for assigned projects regarding population health.
• Working intensively with vendors related to recommendations