Healthcare Consultant I

SGS Consulting
Florida

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.
Posted 2025-11-14

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