Healthcare Consultant I

DO NOT CROSS SUBMIT CANDIDATES ON OTHER S. FLORIDA POSTINGS, THEY WILL BE REJECTED Client max bill rate *** **** Must put the city, state and zip code they reside in at top of resume. **** Location: Work from Home. Candidates must reside in Miami Dade County, FL (West Hialeah) (33010, 33012, 33013, 33014, 33015, 33016, 33018, and 33027). Training will be conducted remotely via Microsoft Teams for approximately 4-6 weeks. Candidate will travel approximately 75% of the time within the region seeing Members at home, in assisted living facilities and nursing homes. Qualifications: FLUENT Bilingual Spanish/English REQUIRED (both reading and speaking and writing) Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Effective communication skills, both verbal and written We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. Our organization promotes autonomy through a Monday-Friday working schedule and flexibility as you coordinate the care of your members. 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 medically complex members. Develops 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.


Position Summary:


Location: Work from home. Candidates must reside in Miami Dade County, FL (Hialeah - (33010, 33012, 33013, 33014, 33015, 33016, 33018, and 33027). Training will be conducted remotely via Microsoft Teams for approximately 4-6 weeks.
Candidate will travel approximately 75% of the time within the region seeing members at home, in assisted living facilities and nursing homes.
FLUENT Bilingual Spanish/ English REQUIRED


Preferred Qualifications:
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Effective communication skills, both verbal and written


Duties:


Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order 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.


Experience:


Case management experience required
Long term care experience preferred
Microsoft Office including Excel competent


Education:


Bachelor's degree required - No Nurses. Social work degree or related field. Candidates must reside in Hialeah.