Healthcare Consultant I

Sourcing for Macon County with a focus on areas around Decatur.

PLEASE INCLUDE LOCATION ON RESUME
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:

Willing and able to travel using your own vehicle 50-75%
of their time to meet with members face to face in Macon co. and surrounding counties.
IL and surrounding areas (Must have reliable
transportation and a drivers license)
Facilitate appropriate healthcare outcomes for waiver/LTSS
members by providing care coordination, support and
education for members through the use of care
management tools and resources.
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

Experience:

Minimum of 2 years of experience in behavioral health or
social services field or human services.
Must have 2+ years of experience in case management
*Willing and able to travel using your own vehicle 50-75%
of their time to meet with members face to face in Macon County and surrounding areas (Must have reliable
transportation and a drivers license)

Education:

Bachelor's degree in social services, human services or
behavioral health.