Clinical Case Manager

Job Description

Job Description

Position Summary:

• Candidate must be located in Bradenton FL zip codes (34221, 34212, 34205 ) - (Hillsborough County) only. The candidate must be Bilingual- (Spanish-English).
• Training will be conducted remotely via Microsoft Teams.
• Candidate will travel approximately 75% of the time within the region seeing Members at home, in assisted living facilities and nursing homes.

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.
  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 member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member 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.

Experience:

• One year Case management experience A MUST / Case Management Certificate ( Preferred)
• ** Long term care experience (Preferred)
• ***Microsoft Office including Excel, Outlook- competent
• ** 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

Education:

• Bachelor's degree required - No nurses. Social work degree or related field preferred.

Software Galaxy Systems, LLC (SGS) is an award-winning Contingent Workforce Services firm providing a broad range of integrated suite of services through a global delivery platform. SGS brings innovative talent management strategies to empower its clients to stay focused on growth of their core competencies. SGS has developed a comprehensive process-oriented methodology to manage high-volume contingent labor, payroll services and SOW’s for today’s competitive landscape.

SGS is proud of the partnerships it has built with its clients, MSP’s, and employees which has allowed it to deliver unparalleled service to its wide-ranging customer base. SGS is a certified minority owned enterprise that provides innovative yet practical solutions, from concept through execution. We combine technology with strategy and aim to deliver results today that endure tomorrow. SGS’ client centric approach delivers unparalleled value with vastly responsive, streamlined and highly process oriented workforce solutions.

SGS has been awarded and acknowledged by leading MSP’s (i.e., KellyOCG, TAPFIN, Guidant Global, etc.) for its exemplary performance in the contingent workforce space.

Company Description

Software Galaxy Systems, LLC (SGS) is an award-winning Contingent Workforce Services firm providing a broad range of integrated suite of services through a global delivery platform. SGS brings innovative talent management strategies to empower its clients to stay focused on growth of their core competencies. SGS has developed a comprehensive process-oriented methodology to manage high-volume contingent labor, payroll services and SOW’s for today’s competitive landscape.\r\n\r\nSGS is proud of the partnerships it has built with its clients, MSP’s, and employees which has allowed it to deliver unparalleled service to its wide-ranging customer base. SGS is a certified minority owned enterprise that provides innovative yet practical solutions, from concept through execution. We combine technology with strategy and aim to deliver results today that endure tomorrow. SGS’ client centric approach delivers unparalleled value with vastly responsive, streamlined and highly process oriented workforce solutions.\r\n\r\nSGS has been awarded and acknowledged by leading MSP’s (i.e., KellyOCG, TAPFIN, Guidant Global, etc.) for its exemplary performance in the contingent workforce space.