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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
Determines medical necessity / appropriateness Facilitates optimal outcomes Identifies and follow through with continuous quality / compliance opportunities.
Duties :
Services strategies policies and programs are comprised of network management and clinical coverage policies.
Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member’s level of work capacity and related restrictions / limitations.
Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality.
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
Utilizes case management processes in compliance with regulatory and company policies and procedures.
Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Productivity and quality expectations. Work requires the ability to perform close inspection of handwritten and computer generated documents.
Work requires sitting for extended periods, talking on the telephone, travel to member’s homes and typing on the computer.
Experience
Education
About US Tech Solutions :
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
To know more about US Tech Solutions, please visit www.ustechsolutions.com .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Last updated : 2024-05-21
Full Time
IT Outsourcing & Consulting
$71k-86k (estimate)
04/30/2024
05/23/2024
ustechsolutions.com
JERSEY CITY, NJ
1,000 - 3,000
1977
Private
MANOJ AGARWAL
$200M - $500M
IT Outsourcing & Consulting
US Tech is an on demand staffing company that provides workforce solutions to business customers.
The job skills required for Healthcare consultant include Planning, Case Management, Decision Making, Interviewing, etc. Having related job skills and expertise will give you an advantage when applying to be a Healthcare consultant. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Healthcare consultant. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Healthcare consultant positions, which can be used as a reference in future career path planning. As a Healthcare consultant, it can be promoted into senior positions as an Intake Coordinator that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Healthcare consultant. You can explore the career advancement for a Healthcare consultant below and select your interested title to get hiring information.