Healthcare Consultant I - Citrus Park/ Carolwood Area Job at SGS Consulting, Florida

VjlWbVg3VDdUWGhtSURHbThTVnMydHFxN2c9PQ==
  • SGS Consulting
  • Florida

Job Description

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 through the use of 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
  • Help 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:

  • Bilingual Spanish/English
  • Case management experience required
  • Long term care experience preferred
  • Strong in Microsoft Office including Excel

Education/Experience:

  • Bachelor's degree required - No nurses. Needs to be Social work degree or related field.

Job Tags

Work at office

Similar Jobs

Kidilum

Bartender Job at Kidilum

 ...techniques. Leadership: Train, mentor, and support junior bartenders and barbacks, ensuring consistent execution and adherence to service...  ...management to provide seamless guest experiences across the restaurant. What We Offer Opportunities for creative input into... 

Amergis

Travel CT Tech Job at Amergis

The CAT/CT Scan Technologist produces computerized tomography scanner radiographs of specific areas as ordered by a physician. These...  ...Radiation licenseCA fluoroscopy licenseAt least 2 years of CT Tech experience - RequiredBenefits:Competitive pay & weekly paychecks... 

Confidential

Government Healthcare Financial Consultant Job at Confidential

 ...are seeking a talented individual to join our Government Healthcare Services Consulting (GHSC) team at Mercer, a Marsh business . This role can...  ...hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development... 

Scale AI

Software Engineer - New Grad Job at Scale AI

 ...Ship tools to accelerate the growth of new qualified contributors on Scales labeling...  ...field (Computer Science, EECS, Computer Engineering, Statistics) Product engineering...  ...and then iterating Previous Product/Software Engineering Internship experience Track... 

Lifesteps Inc

Accountant - Part-time Job at Lifesteps Inc

 ...Lifesteps in Butler, PA is hiring a part-time Accountant to assist the Fiscal and Accounting Department with preparing financial records and reports. Lifesteps is a non-profit, human services organization which has been serving Western Pennsylvania for over 100 years...