Healthcare Consultant I

Mention: Address on TOP OF RESUME
Location: within the Ogle County
The zips we re targeting would be:
61021, 61068, 61010, 61064, 61054, 61020, 61047, 61084, 61030, 61078, 61006
this isn t exhaustive, but generally
these are the zips, and some surrounding these.
Remote never onsite but Field Work
*Willing and able to travel using your own vehicle 50-75% of their time to meet with members face to face in Ogle County and surrounding areas (Must have reliable transportation and a valid drivers license)
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:

*Willing and able to travel using your own vehicle 50-75%
of their time to meet with members face to face in north
Chicago 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

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 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 north
Chicago and surrounding areas (Must have reliable transportation and a drivers license)

Education:

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