Professional Management Enterprises, Inc.

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Contract Oct 21, 2024 Call Center Job Description: Intermediate knowledge of training processes, such as adult learning theories and instructional design principles. Effective facilitation skills, such as ability to facilitate open discussion in a less structured environment. Effective class preparation skills. Ability to coordinate cross state tasks and to interact with employees in all areas of the project. Ability to analyze effectiveness of training and to independently implement, with guidance from the training supervisor, appropriate solutions without compromising instructional design and adult learning theory. Ability to coach others and provide performance feedback (e.g. trainees, agents, etc.) Travel within the State of Indiana REQUIREMENTS: Education: Some college with 1 plus years experience in facilitation/trainer role or HS diploma or GED and 2 plus years experience with Indiana Eligibility Public Assistance Programs. Must be able to travel 20% - 40% within the State of Indiana Extensive knowledge of Policy and Guidelines in relation to Indiana Eligibility Public Assistance Programs (TANF, Medicaid, SNAP Preferred Experience working in IEDSS Bachelor’s Degree Coaching or training experience Training Certification Excellent communication & presentation skills PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract Oct 17, 2024 Administrative ESSENTIAL DUTIES MAY INCLUDE: • Following policy in critical incidents preventing injury, escape, or property damage. • Maintains confidentiality. • Incumbent supervises the daily work of students and evaluates the achievement of individual student knowledge. • Operates all job-related equipment. • Collaborates with other departments in order to enhance the learning environment of students. • Providing written reports to/participates in multidisciplinary treatment team. • Attending and successfully completing all required training and certifications. • Developing and reviewing clear, accurate, and concise reports that are in compliance with departmental policies and procedures. • Promoting good working relationship with students, staff, contractual personnel, interns and volunteers, and applicable community public or private agencies. • Maintaining a positive image to the public in all related responsibilities. • Performs related duties as assigned. REQUIREMENTS: • Ability to implement daily and weekly teacher lesson plans designed to enforce full course objectives in the absence of an educator. • Ability to create and provide a positive learning environment conducive to and supportive of individual growth and development of students. • Ability to maintain and control educational department supplies, equipment, and tools. • Ability to effectively communicate both orally and written. • Ability to work effectively in a teamwork environment. • Ability to accept supervision and constructive feedback. • Ability to test negative on all drug tests. • Ability to successfully complete all required training and certifications.
Contract Oct 17, 2024 Healthcare Essential Duties/Responsibilities: Administers medications and treatments in accordance with all accepted standards for administration; Provides safe, efficient personal care of residents; Uses recommended safety devices and follows infection control standards; Answers call lights and residents' requests for assistance; Adheres to resident's rights at all times; Documents medications and treatments administered, and care provided; Assists with orientation of new employees on the unit; Participates in resident care planning, updating care plans and aide assignments; Assesses residents, documents findings and reports to the physician; Transcribes physicians orders; Communicates resident change of condition to resident sponsors; Destroys and documents same of discontinued medications; Maintains correct controlled substance numbers during shift; Completes required documentation of nursing notes, transfer forms and other records; Assists with operation of the unit, including the monthly change over of records; Completes and distributes nurse aide assignments; Gives report to on-coming shift. Schedule and assist with physician, optometrist, podiatrist, dentist appointments; Administer and record employee health testing results Job Requirements: Must be licensed as and maintain licensure as a Licensed Practical Nurse in Indiana; must maintain first aid, mantoux and CPR certification. Ability to understand and communicate with residents and understand and complete nursing forms; ability to follow verbal instructions; ability to provide nursing care practices; ability to use medical equipment within scope of licensure; ability to provide safe, efficient resident care, following all applicable state and Veterans' Administration rules, IVH policies and procedures and all HIPAA rules; must attend and complete all required in-service training; ability to prioritize workload; ability to be flexible; ability to assess resident's and report to the physician; ability to administer medications and treatments in a safe, efficient manner, recognizing medication side effects; ability to know approved abbreviations and appropriate terminology; ability to document in a legible manner.
Contract Oct 15, 2024 Healthcare Essential Duties/Responsibilities: Administers medications and treatments in accordance with all accepted standards for administration; Provides safe, efficient personal care of residents; Uses recommended safety devices and follows infection control standards; Answers call lights and residents' requests for assistance; Adheres to resident's rights at all times; Documents medications and treatments administered, and care provided; Assists with orientation of new employees on the unit; Participates in resident care planning, updating care plans and aide assignments; Assesses residents, documents findings and reports to the physician; Transcribes physicians orders; Communicates resident change of condition to resident sponsors; Destroys and documents same of discontinued medications; Maintains correct controlled substance numbers during shift; Completes required documentation of nursing notes, transfer forms and other records; Assists with operation of the unit, including the monthly change over of records; Completes and distributes nurse aide assignments; Gives report to on-coming shift. Schedule and assist with physician, optometrist, podiatrist, dentist appointments; Administer and record employee health testing results Job Requirements: Must be licensed as and maintain licensure as a Licensed Practical Nurse in Indiana; must maintain first aid, mantoux and CPR certification. Ability to understand and communicate with residents and understand and complete nursing forms; ability to follow verbal instructions; ability to provide nursing care practices; ability to use medical equipment within scope of licensure; ability to provide safe, efficient resident care, following all applicable state and Veterans' Administration rules, IVH policies and procedures and all HIPAA rules; must attend and complete all required in-service training; ability to prioritize workload; ability to be flexible; ability to assess resident's and report to the physician; ability to administer medications and treatments in a safe, efficient manner, recognizing medication side effects; ability to know approved abbreviations and appropriate terminology; ability to document in a legible manner.
Contract Oct 11, 2024 Other Area(s) Care Manager (RN) with Prenatal, Postpartum, Labor/ Delivery, Mother Baby or NICU experience to develop, assess, and facilitate complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Fully remote but MUST reside in Indiana. The work schedule is Monday-Friday 8am-5pm.   Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs Care Manager completes an average of 40-50 calls per day reaching out to members who are about to or have recently delivered a baby. Conduct assessments to assess members well-being, newborn wellbeing and to assist with any needs Assist members on scheduling postpartum appointments Answer questions about postpartum and Newborn care. Documenting in specific system Education/Experience: Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 – 4 years of related experience. License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required
Contract Oct 10, 2024 Other Area(s) Job Title: (RN) Well Care Coordinator Location:  Remote (Bloomington, Indiana) **Must be an Indiana Resident Hours: Monday - Friday 8am-5pm Pay:  $48hr weekly pay Travel Requirement: 25% - 50% Job Summary: The Community Well Care Coordinator must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordinator must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordinator will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordinator will provide input, as requested by the State, at State-level meetings. Primary Responsibilities: •    Selects, manages, develops, mentors and supports staff in designated department or region •    Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results •    In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements •    Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements •    Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence •    Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care •    Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services •    Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members •    Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team •    Participates in training and coaching of direct reports as needed •    Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship •    Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders Required Qualifications: •    Resident of Indiana •    BSN with equivalent experience •    Registered Nurse with an unrestricted License in Indiana •    Experience working within the community health setting in a health care role •    Experience or knowledge of Indiana Medicaid, Medicare, Long term care •    Experience coaching or mentoring staff •    Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment Preferred Qualifications: •    3+ year of case management leadership experience within a healthcare industry •    Background in managed care •    Case Management experience •    Certified Case Manager (CCM) •    Experience / exposure with members receiving long term social supports •    Experience in utilization review, concurrent review and/or risk management PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.  
Contract Sep 30, 2024 Healthcare ilingual candidates are encouraged to apply! Involved in the development, presentation and delivery of community outreach initiatives, activities and market strategies to support the Medicaid business and drive membership retention and growth. Must be an Indiana resident who resides in or near Marion County, Indiana, willing to travel throughout central and northern Indiana Conduct outreach activities for community members that are Aged, Blind, and Disabled Collaborate with local agencies and medical providers that serve the HCC and PathWays populations Educate and network with people of diverse backgrounds and cultures Report feedback from the field to further develop and enhance UHCCP programming Minimum Qualification, Training, and Experience: Five or more years of education and/or experience in the health services field, with a preference for a candidate who is a Certified Community Health Worker preferred Valid Indiana driver’s license required Reliable transportation required Travel up to 75% of the time within assigned territory Willing to work a flexible 40-hour week, including evenings and weekends Able to transport, lift, carry and set up promotional materials Smartphone capable of installing Microsoft Office, Zoom, SalesForce, Google Drive, Slack and others, as necessary Basic computer skills and knowledge of office programs, with the ability to learn new ones Experience in outreach and linking the community to local resources Able to deliver presentations and conduct meetings Flexible to adjust job responsibilities as the position evolves
Contract Sep 26, 2024 Healthcare PME is actively seeking a CNA FT/PRN to assists with nursing programs as assigned. Performs a variety of tasks associated with the daily care and treatment of patients. Job Responsibilities: Administers and documents authorized medications and treatments per hospital policies and procedures. Carries out or assists with physical care of patients including bathing, feeding, taking vital signs, heights, weights, and other activities of daily living as indicated. Maintains current CPR and Bridge Building certifications. Escorts patients to and from therapies, and other areas of the hospital for treatment and programming. Escorts and/or drives patients to off-ground appointments and activities. Observes patients’ physical condition and reports changes to the RN. Appropriately and accurately reports pertinent information, both verbal and written. Appropriately applies skills in psychosocial care of patients: Encourages patients and interacts with them to socialize and participate in activities and programming. Job Requirements: High school diploma or GED Equivalent Successful completion of a Certified Nursing Assistant program Basic computer skills are required. Maintain current CPR. Bridge Building certification.
Contract Sep 3, 2024 Other Area(s) RN Case Manager to conduct UAS Assessments to support care management. The position will be a field position in Syracuse, Albany or Orange, NY.  Schedule will be M-F 8:30AM-5PM. ***MUST be RN UAS Certified. Bilingual in any language is highly preferred. Essential Functions/Responsibilities: UAS Certified RN licensed in the state of NY. Conduct face to face assessments of members’ functional status, medical, behavioral, psychosocial and community resource needs. Provides the Interdisciplinary Care Team (ICT) with assessment information and acts as facilitator to ensure that members’ needs are met. Develop an ICP/PCSP based on members’ clinical, behavioral, and social needs that addresses barriers to care. Competently assesses members’ health status and ensures that member is receiving all necessary medical and supportive services. Manage care transitions through effective and timely communication necessary for member care and discharge planning. Clarifies SWH plan medical benefits, policies and procedures for members, providers and community-based agencies. Maintain a comprehensive working knowledge of community resources, payer requirements, and network services for target population. Required Education: Bachelor's Degree (a combination of experience and education will be considered in lieu of degree). Required Licensure/Certification: NY State RN License in good standing.
Contract Aug 19, 2024 Healthcare The Community Well Care Coordinator must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordinator must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordinator will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordinator will provide input, as requested by the State, at State-level meetings. Primary Responsibilities: •    Selects, manages, develops, mentors and supports staff in designated department or region •    Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results •    In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements •    Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements •    Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence •    Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care •    Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services •    Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members •    Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team •    Participates in training and coaching of direct reports as needed •    Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship •    Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders Required Qualifications: •    Resident of Indiana •    BSN with equivalent experience •    Registered Nurse with an unrestricted License in Indiana •    Experience working within the community health setting in a health care role •    Experience or knowledge of Indiana Medicaid, Medicare, Long term care •    Experience coaching or mentoring staff •    Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment Preferred Qualifications: •    3+ year of case management leadership experience within a healthcare industry •    Background in managed care •    Case Management experience •    Certified Case Manager (CCM) •    Experience / exposure with members receiving long term social supports •    Experience in utilization review, concurrent review and/or risk management PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract Aug 19, 2024 Healthcare The Community Well Care Coordinator must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordinator must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordinator will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordinator will provide input, as requested by the State, at State-level meetings. Primary Responsibilities: •    Selects, manages, develops, mentors and supports staff in designated department or region •    Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results •    In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements •    Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements •    Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence •    Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care •    Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services •    Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members •    Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team •    Participates in training and coaching of direct reports as needed •    Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship •    Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders Required Qualifications: •    Resident of Indiana •    BSN with equivalent experience •    Registered Nurse with an unrestricted License in Indiana •    Experience working within the community health setting in a health care role •    Experience or knowledge of Indiana Medicaid, Medicare, Long term care •    Experience coaching or mentoring staff •    Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment Preferred Qualifications: •    3+ year of case management leadership experience within a healthcare industry •    Background in managed care •    Case Management experience •    Certified Case Manager (CCM) •    Experience / exposure with members receiving long term social supports •    Experience in utilization review, concurrent review and/or risk management PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract Aug 17, 2024 Healthcare The Community Well Care Coordinator must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordinator must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordinator will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordinator will provide input, as requested by the State, at State-level meetings. Primary Responsibilities: •    Selects, manages, develops, mentors and supports staff in designated department or region •    Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results •    In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements •    Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements •    Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence •    Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care •    Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services •    Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members •    Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team •    Participates in training and coaching of direct reports as needed •    Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship •    Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders Required Qualifications: •    Resident of Indiana •    BSN with equivalent experience •    Registered Nurse with an unrestricted License in Indiana •    Experience working within the community health setting in a health care role •    Experience or knowledge of Indiana Medicaid, Medicare, Long term care •    Experience coaching or mentoring staff •    Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment Preferred Qualifications: •    3+ year of case management leadership experience within a healthcare industry •    Background in managed care •    Case Management experience •    Certified Case Manager (CCM) •    Experience / exposure with members receiving long term social supports •    Experience in utilization review, concurrent review and/or risk management PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract Jul 29, 2024 Other Area(s) Senior Care Manager to assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care givers on services and benefit options available to receive appropriate high-quality care. The position is fully remote but may require onsite quarterly meetings. The schedule is M-F, 8:00am-5:00pm. Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team. Reviews member data to identify trends and improve operating performance and quality care. Reviews referrals information and intake assessments to develop appropriate care plans/service plans. May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources. Develops and continuously assesses ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources needed to address member's unmet needs. Education/Experience: Requires a Degree from an Accredited School or Nursing or a Bachelor's degree in Nursing 4 – 6 years of related experience. License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required