Healthcare Consultant I
Job Responsibilities:
- Develop 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 Coordinator will determine appropriate services and support due to members’ health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.
- 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:
- Case management experience required, long term care experience preferred
- Microsoft Office including Excel competence
- Bilingual Spanish/English Required
Education/Experience:
- Bachelor's degree required
- No nurses
- Social work degree or related field.
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