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Job Requirements of Healthcare Consultant I:
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Employment Type:
Contractor
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Location:
Tallahassee, FL (Onsite)
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Healthcare Consultant I
Careers Integrated Resources Inc
Tallahassee, FL (Onsite)
Contractor
Job Title: Healthcare Consultant I
Job Location: Tallahassee, FL
Job Duration: 3-4 Months (possibility of extension)
Job Summary:
Job Location: Tallahassee, FL
Job Duration: 3-4 Months (possibility of extension)
Job Summary:
- We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy.
- Bilingual in Spanish/English 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.
- Case Management Coordinator will effectively manage a caseload that includes supportive and medically complex members.
- Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
- Case Management Coordinators will determine appropriate services and supports due to member’s health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.
- 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.
- Bachelor's degree required - No nurses.
- Social work degree or related field.
- Minimum 1 year of relevant experience.
- Case management experience required.
- Long term care experience preferred.
- Microsoft Office including Excel competent.
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