Healthcare Consultant I

SGS_JOB_1390

Business Support
 Florida
Case Management
Excel
Microsoft Office

Contract - 03 Months Extendable

The 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

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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