Field Case Management Coordinator
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, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members using 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
- Helps 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:
- One year Case management experience A MUST / Case Management Certificate (Preferred)
- ** Long term care experience (Preferred)
- ***Microsoft Office including Excel competent
- ** Bilingual - Spanish / English (required)
Education/Experience:
- Bachelor's degree required - No nurses. Social work degree or related field preferred.
Recommended Jobs
Utility
~ Great Pay $15.00 per hour ~ Full-time positions available. ~ Great Benefits ~ Referral Bonuses ~2 Weeks PTO (Paid Time Off) ~ Great Advancement Opportunities Our Utility/Dishwasher …
Partner Account Manager
Who are we? Equinix is the world’s digital infrastructure company®, shortening the path to connectivity to enable the innovations that enrich our work, life and planet. A place where bold idea…
Operations Associate
Sephora is seeking an Operations Associate in Miami to support store operations, manage inventory, and assist with visual merchandising. This part-time role requires 1-2 years of experience in retail …
Experienced Speciality Vet Tech (Onco, Surg or Anesthesia)
Who are we? What if we could create a community of supportive veterinary professionals that collectively used their individual strengths to contribute to the care of all pets? One where animal welfar…
Sales Agent
Currently, we are not hiring International candidates. We take immense pride in our company's achievements. For two consecutive years, Entrepreneur Magazine has honored us with the esteemed title …
Locum MD (Medical Doctor), DO (Osteopathic Doctor) Neurology
Description This on-site, contract position is located in Orange Park and offers a unique opportunity to provide high-quality neurological care in a supportive medical practice environment. As …
Primary Care Opportunity - Central Florida!
Primary Care Opportunity - The Villages, FL! There is a major growth trend in The Villages, FL! Live one hour of Orlando! Affordable cost of living Have all the amenities at your find tips o…
Overnight Guest Service Agent (Part-Time) - Signia by Hilton Orlando
The Signia by Hilton Orlando Bonnet Creek is seeking a Part-Time Overnight Guest Service Agent to join their team! The ideal candidate will have a minimum of two years of customer service experien…
Manager, Project Architect
Journey with us!Combine your career goals and sense of adventure by joining our incredible team of employees at Royal Caribbean Group . We are proud to offer a competitive compensation and benefits…
Facility Coordinator
Summary: The Facilities Coordinator plays a pivotal role in supporting and overseeing a small team of multi-skilled operatives while ensuring smooth day-to-day operations of facilities services. Th…