Case Manager - Healthcare Consultant

JOB DETAILS BELOW:

Job Title:       Healthcare Consultant – Case Manager

Location:       Miami Dade County, FL (Remote Field Visit)

Hours:           40-hrs. in a week

Pay Rate:      $36/hr. on w2 and mileage is reimbursable

Shift: Monday - Friday 8 am to 5 pm (EST)

Position Summary:

• Training will be conducted remotely via Microsoft Teams for approximately 4-6 weeks.
• Candidate will travel approximately 75% of the time within the region seeing members at home, in assisted living facilities and nursing homes.
• FLUENT in English / Spanish required.

Preferred Qualifications:

·        Bilingual Spanish/English.

·        Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment.

·        Effective communication skills, both verbal and written.

Duties::

• Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Utilizes critical thinking and judgment to collaborate and inform the case management process, in order 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 member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member 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.

Experience:

·        Case Management experience required.

·        Long term care experience preferred.

·        Microsoft office including excel competent.

Required Qualifications:

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