Healthcare Consultant III

This role will be primarily WFH and you can source candidates from anywhere in OH. There might be some possible travel needed. If it is, travel assignments will be based from the location of the candidates hired - so you may submit candidates anywhere in OH. Travel will be minimum and likely more toward later in the year if needed.





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



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



Duties:



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?



Experience:



- Minimum 5 years of relevant experience



Education:



Master's Degree in Social Work