Healthcare Consultant I - North Miami

SGS_JOB_2396

Business Support
 Florida
Case Management
Case Management
Case Management Coordinator

Contract - 03+ Months

Location : North Miami, FL. 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. Case Management Coordinator will effectively manage a caseload that includes supportive and complex members. 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 Coordinators will determine appropriate services and supports due to 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. Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.

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, 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 members’ 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.

Related Jobs

Patient Centricity MIPI Fellow

Business Support
Remote
24 Months

The Patient Centricity MIPI Fellow supports patient-focused research initiatives within the Medical Intelligence and Patient Insights team. This entry-level role involves working with cross-functional teams to generate insights on disease burden, patient experience, and healthcare utilization to support strategic decisions in research and development

Patient-centric research
epidemiology
healthcare analytics
patient journey mapping
stakeholder management
health economics
data analysis
scientific communication
Microsoft PowerPoint
Excel
Word
Teams

Recruiter I

Business Support
 North Carolina
03 months

Location (mandatory): Charlotte, NC 28217 Seeking a motivated Recruiter with 1-3 years of experience to manage the end-to-end hiring process for professional roles. As a key member of our talent acquisition team, you will proactively identify staff vacancies, source and screen quality candidates, and efficiently manage applicant pipelines across multiple recruiting platforms. This position also emphasizes relationship-building with external partners to support both immediate hiring needs and future talent pipelines.

Full-cycle recruiting
Candidate sourcing
Resume screening
Interview coordination
Talent pipeline
ATS management
Stakeholder collaboration
Relationship building
and Recruiting platforms

Print Mgmt. First Responder

Business Support
 South Carolina
03+ Months Extendable

Location : Mount Pleasant, SC 29464. This role's focus will be on the printer fleet. Basic troubleshooting and technical capabilities with printers are important skills for this position

Print Production
Printing
Digital Printer
Copier
Mailroom
printer fleet

Print Production

Business Support
 Minnesota
03+ Months Extendable

Location : Chanhassen, MN 55317. Shift: Standard normal work hours depending on location. Dress Code: Pharmacy High volume print production, attention to detail, must be tech savvy and ability to work internet browser, MS Outlook, and advanced print portal (or similar applications), dependable, self-starter, lift to 50lb (cases of paper), friendly and ability to get along with multiple personalities.

Print Production
Printing
Digital Printer
Copier
Mailroom

Marketing Manager: Retail Experience Strategy

Business Support
 Rhode Island
06+ Months Extendable

Location : Hybrid (Woonsocket, RI 02917) Shift: Standard normal work hours depending on location. Dress Code: Pharmacy As a Marketing Manager on the Retail Experience Strategy team, you will play a pivotal role in delivering and optimizing innovative pilot experiences across locations. You will lead the execution of in-store marketing initiatives, events, and ensure all elements are well executed, impactful, and enhance the overall experience that supports our goals. Your work will help transform our retail spaces into beloved destinations for our customers, colleagues, and the local communities we serve. Together, we aim to elevate the in-store experience, driving stronger engagement, growth, and long-term value.

Retail
Marketing
Stores
store operation
Consumer Insight

Medicare Marketing Materials Consultant

Business Support
Remote
$27-30/hr. on W2
03+ Months Extendable

Shift: Standard normal work hours depending on location. Dress Code: Pharmacy This position will independently conduct Quality Assurance reviews on Medicare member materials. The QA will consist of reviewing PDF documents alongside Source of Truth documentation to ensure accuracy of the materials. The materials include benefit information, cost-sharing, and explanations of how the plans work. We work on a timeline to get these documents accurate, verified, and mailed, so time and precision are of the essence.

CMS
Proof-reading
proofread
proofreading
Medicare
Quality Check
Data Analysis
Evidence of Coverage (EOC)
Annual Notice of Change (ANOC)
Marketing Materials
Drafting

Analyst I Operations Reporting and Workflow Coordinator

Business Support
 Texas
03+ Months Extendable

Location : Irving, TX (remote but need around driving area) Shift: Standard normal work hours depending on location. The Operations Reporting & Workflow Coordinator is responsible for driving operational efficiency through data analysis, ticket management, and stakeholder collaboration.

Data Analysis
Ticket Management
Excel
Power BI
Tableau
Jira
Servicenow
Zendesk

Healthcare Consultant I - SW Ohio

Business Support
 Ohio
03+ Months Extendable

Candidates must reside in one of these counties: Central/Southeast OHIO Counties ** Candidates could be required to travel to the corporate office in Franklin County for onsite meetings. These usually happen 1-2 times a year. ** Travel to office is not reimbursable.

Bilingual
Spanish
Healthcare consultant
Case Management
Case Manager
Case Management Coordinator

Healthcare Consultant I - SW Ohio

Business Support
 Ohio
03+ Months Extendable

Location (mandatory): SW OHIO Counties: Adams, Allen, Auglaize, Brown, Butler, Champaign, Clark, Clermont, Clinton, Darke, Defiance, Fulton, Green, Hamilton, Hardin, Henry, Lawrence, Logan, Lucas, Madison, Mercer, Miami, Montgomery, Paulding, Preble, Putnam, Scioto, Shelby, Van Wert, Warren, Williams in OHIO ): Candidates must reside in one of these counties: SW OHIO Counties: Adams, Allen, Auglaize, Brown, Butler, Champaign, Clark, Clermont, Clinton, Darke, Defiance, Fulton, Green, Hamilton, Hardin, Henry, Lawrence, Logan, Lucas, Madison, Mercer, Miami, Montgomery, Paulding, Preble, Putnam, Scioto, Shelby, Van Wert, Warren, Williams ** Candidates could be required to travel to the corporate office in Franklin County for onsite meetings. These usually happen 1-2 times a year. **

Bilingual
Spanish
Healthcare consultant
Case Management
Case Manager
Case Management Coordinator
logo

At SGS Consulting, we go beyond resume-job matches, creating meaningful connections and pathways for individuals to thrive in defining careers.


© 2026 All rights reserved.
logologologologo