You haven't searched anything yet.
Position Summary :
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program / operational efficiency involving clinical issues
Determines medical necessity / appropriateness Facilitates optimal outcomes Identifies and follow through with continuous quality / compliance opportunities .
May also include identification of aberrance's and initiation of corrective action Educates / empowers customers to ensure compliance, satisfaction and promote patient advocacy Optimize total costs Implementation and evaluation of policy based on usage and program directives Educate / empower colleagues at all levels to enable decision making at most appropriate level
Duties :
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, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
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
Utilizes influencing / motivational interviewing skills to ensure maximum member engagement and promote lifestyle / behavior changes to achieve optimum level of health
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
Monitoring, Evaluation and Documentation of Care :
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Experience :
Case management experience required
Long term care experience preferred
Microsoft Office including Excel competent
Position Summary
Location : Work from Home. Candidates must reside in Miami Dade County, FL.
Training will be conducted remotely via WebEx for approximately 1-2 weeks.
Members at home, in assisted living facilities and nursing homes.
Preferred Qualifications :
Bilingual Spanish / English
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Effective communication skills, both verbal and written
Education
Bachelor’s degree required - No Nurses. Social work degree or related field.
Experience
Minimum 1 year of relevant experience in case management.
Skills :
Social work, Case management, Spanish
About US Tech Solutions :
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
To know more about US Tech Solutions, please visit .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Last updated : 2024-06-14
Full Time
IT Outsourcing & Consulting
$64k-78k (estimate)
04/24/2024
06/22/2024
ustechsolutions.com
JERSEY CITY, NJ
1,000 - 3,000
1977
Private
MANOJ AGARWAL
$200M - $500M
IT Outsourcing & Consulting
US Tech is an on demand staffing company that provides workforce solutions to business customers.
The job skills required for Healthcare consultant include Social Work, Case Management, Microsoft Office, Coaching, Decision Making, Interviewing, etc. Having related job skills and expertise will give you an advantage when applying to be a Healthcare consultant. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Healthcare consultant. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Healthcare consultant positions, which can be used as a reference in future career path planning. As a Healthcare consultant, it can be promoted into senior positions as an Intake Coordinator that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Healthcare consultant. You can explore the career advancement for a Healthcare consultant below and select your interested title to get hiring information.