Healthcare Consultant II

Client max bill rate: ***
Supplier max bill rate: ***

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 .
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 members at all levels to enable decision making at most appropriate level
Complete transition of care protocol and follow up which includes a post discharge assessment and care plan updates

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 .
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
Complete transition of care protocol and follow up which includes a post discharge assessment and care plan updates

Experience:

- Minimum 2 years of clinical experience
- RN with unrestricted Ohio or compact license
- Effective communication skills, both verbal and written
- Ability to multitask, prioritize and effectively adapt to a fast paced changing environment

Education:

Minimum of an associated degree in nursing
RN license that is active and unrestricted in Ohio or compact state