Healthcare Consultant I (266545)

Job Description

Job Description

"All candidates must be directly contracted by ASK Consulting on their payroll and cannot be subcontracted. We are unable to provide sponsorship at this moment".

Job Title: Healthcare Consultant I

Duration: 3 Months

Location: Miami Dade, FL (ZIP CODES: 33010, 33012, 33013)

Pay Rate: $30/hr. - $34/hr.

Shift: M-F 8-5

Job Description:

Position Summary:

We are seeking a self-motivated, energetic, detail-oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. This opportunity offers a competitive salary and full benefits. Our organization promotes autonomy through a Monday-Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members. Case Management Coordinator is responsible for telephonically and/or face-to-face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. The Case Management Coordinator will effectively manage a caseload that includes supportive and medically complex members. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member's overall wellness through integration. Case Management Coordinators will determine appropriate services and supports due to the member's health needs, including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.

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 a 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 the 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.

Required experience :

• Case management experience required
• Long-term care experience preferred
• Microsoft Office, including Excel, is competent
• Must be fluent in speaking Spanish, and be able to have a full conversation

Preferred:

• Case Management experience in an integrated model.
• Bilingual preferred.
• Working knowledge of problem-solving and decision-making skills.
• Working knowledge of medical terminology.
• Working knowledge of digital literacy skills.
• Ability to deal tactfully with customers and the community.
• Ability to handle sensitive information ethically and responsibly.
• CCM (Certified Case Manager).
• Remote work experience.

Education:

• Bachelor's degree required-No nurse, social work degree, or related field.

About ASK: ASK Consulting is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Consulting connects people with amazing opportunities

ASK Consulting is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all associates.