Healthcare Consultant I - Citrus Park/ Carolwood Area Job at SGS Consulting, Florida

MGtrN3YrMlZXSXlUM0o0N3lUK0RxbW13QVE9PQ==
  • SGS Consulting
  • Florida

Job Description

Job Responsibilities:

  • Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollers.
  • Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
  • Conducts comprehensive evaluation of Members using care management tools and information/data review
  • Coordinates and implements assigned care plan activities and monitors care plan progress
  • Conducts multidisciplinary review to achieve optimal outcomes
  • Identifies and escalates quality of care issues through established channels
  • Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
  • Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
  • Provides coaching, information and support to empower the members to make ongoing independent medical and/or healthy lifestyle choices
  • Help members actively and knowledgeably participate with their provider in healthcare decision-making
  • Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Skills:

  • Bilingual Spanish/English
  • Case management experience required
  • Long term care experience preferred
  • Strong in Microsoft Office including Excel

Education/Experience:

  • Bachelor's degree required - No nurses. Needs to be Social work degree or related field.

Job Tags

Work at office,

Similar Jobs

Valiant Harbor International, LLC

Senior Project Engineer Job at Valiant Harbor International, LLC

 ...HNJ) Cyber and Network (C&N) Directorate. This role is ideal for a highly skilled engineer, preferably with United States Air Force or DoD experience, who brings deep technical expertise and can partner directly with the IPT Engineering Lead. While engineering expertise... 

KBR

Records and Property Manager Job at KBR

 ...Title: Records and Property Manager Belong. Connect. Grow. with KBR! KBR's National Security Solutions team provides high-end engineering and advanced technology solutions to our customers in the intelligence and national security communities. In this position... 

Medacta USA, Inc.

Clinical Research Associate Job at Medacta USA, Inc.

 ...Position Title: Clinical Research Associate FSLA Status: Salary-Exempt Department: Clinical Research, Medacta USA Location: Franklin...  ...the clinical protocol, and data collection requirements. Assist in reporting and follow-up of clinical unexpected and Serious... 

GA Telesis, LLC

Aircraft Mechanic Apprentice Job at GA Telesis, LLC

 ...countries. The GA Telesis Ecosystem concept is core to our providing integrated aviation solutions to our global customers. Aircraft Mechanic Apprentice position is available for current A&P students. This is an entry-level, full-time position responsible for... 

EA Insurance Agency LLC

Remote Financial Consultant Job at EA Insurance Agency LLC

 ...This is a remote position. We are a remote-first financial services agency expanding our team of licensed professionals who work...  ...door-to-door activity, and no lead scraping. This is a consultative role focused on long-term client value, not a scripted call-center...