Healthcare Consultant I

Job Title: Healthcare Consultant I
Job Duration: 3+ Months (Possibilities of extension)
Shift: Monday-Friday 8a-5p EST
Location: Miami, FL 33130

Location Specificity: Candidates must reside in Miami, FL, within specific zip codes (33182,33172, 33130, 33165). Candidates should list their zip code at the top of their resume.

Language Requirement: Bilingual in English and Spanish is mandatory due to the hiring area.

Position Summary
Provide comprehensive healthcare management services to ensure appropriate treatment, manage healthcare costs effectively, and improve program and operational efficiency. This role focuses on facilitating optimal outcomes, ensuring quality compliance, and promoting patient advocacy through education, support, and care coordination.
Key Responsibilities

• Coordinate case management activities for Medicaid Long Term Care / Comprehensive Program enrollees.

• Implement and evaluate policies based on program directives and usage trends.

• Apply case management and quality processes in compliance with regulatory, accreditation, and company policies.
• Document all member interactions, care plan updates, and outcomes accurately in the system.

Experience & Education

• Required: Case management experience.
• Preferred: Long-term care experience.
• Education: Bachelor s degree in a relevant field (nursing, social work, or related).