Healthcare Consultant I Job at SGS Consulting, Florida

VXEyQjBuZ2pCY21YM2FES00vbnpVeW5NeGc9PQ==
  • 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 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 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
  • 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 competent

Education/Experience:

  • Bachelor's degree required - No Nurses. Social Work degree or related field.

Job Tags

Work at office,

Similar Jobs

Extend

Senior Security Operations Analyst Job at Extend

 ...Senior Security Operations Analyst About Extend: Extend is revolutionizing the post-purchase experience for retailers and their customers by providing merchants with AI-driven solutions that enhance customer satisfaction and drive revenue growth. Our comprehensive... 

AO Globe Life

Customer Service Rep (Remote) - Full/Part-Time | Beginner Friendly & Start ASAP - Job at AO Globe Life

 ..., and long-term growth potential. Why Youll Love Working With Us 100% Remote & Work-From-Home Setup Anywhere in the U.S. Immediate Start Interview...  ...Schedule Choose part-time, full-time, days, or evenings Union-Backed Benefits Life, health, and... 

Par-A-Dice Hotel Casino

Beverage Server Job at Par-A-Dice Hotel Casino

Boyd Gaming Corporation has been successful in gaming jurisdiction in which we operate in the United States and is one of the premier casino entertainment companies in the United States. Never content to rest upon our successes, we will continue to evolve and retain...

Kforce Technology Staffing

Software QA Tester Job at Kforce Technology Staffing

 ...field deployment validation when needed. Requirements Bachelors degree in a technical field. Minimum 3 years of experience in software testing. Strong understanding of test planning, test case writing, and bug reporting. Familiarity with basic database... 

The Boutique Coo

Search Engine Optimization (SEO) Specialist Job at The Boutique Coo

 ...be responsible for building, optimizing, and reporting on SEO campaigns...  ...~2+ years of experience managing SEO campaigns with a track record...  ..., etc.) and Google Analytics/Search Console ~ Deep...  ...optimize for both users and search engines ~ Ability to interpret data...