*Healthcare Consultant I - Miami-Dade County, FL
Healthcare
Description
Job Title
Healthcare Consultant 1
Location
Miami-Dade County, FL
Position Description
This role will require 50-75% travel for face-to-face visits with members in the Hialeah area of Miami-Dade County, FL. We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. Case Management Coordinator is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness.
Roles Responsibilities
• Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Utilizes critical thinking and judgment to collaborate and inform the case management process.
• Conducts comprehensive evaluation of members using care management tools and information/data review.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Conducts multidisciplinary review to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgeably participate with their provider in healthcare decision-making.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Skills
• Must be fluent in English and Spanish.
• Case Management experience required.
• Long Term Care experience preferred.
• Microsoft Office experience required: Excel, Teams, Outlook.
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment.
• Effective communication skills, both verbal and written.
Education
• Bachelor's degree in Social Work or related field required.
Job Title
Healthcare Consultant 1
Location
Miami-Dade County, FL
Position Description
This role will require 50-75% travel for face-to-face visits with members in the Hialeah area of Miami-Dade County, FL. We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. Case Management Coordinator is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness.
Roles Responsibilities
• Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Utilizes critical thinking and judgment to collaborate and inform the case management process.
• Conducts comprehensive evaluation of members using care management tools and information/data review.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Conducts multidisciplinary review to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgeably participate with their provider in healthcare decision-making.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Skills
• Must be fluent in English and Spanish.
• Case Management experience required.
• Long Term Care experience preferred.
• Microsoft Office experience required: Excel, Teams, Outlook.
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment.
• Effective communication skills, both verbal and written.
Education
• Bachelor's degree in Social Work or related field required.