Healthcare Consultant I Job at SGS Consulting, Florida

TDZ2a0VxRU1uQzZNbkVYd0pzRTNManFPZmc9PQ==
  • 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

Waiter.com

Silicon Valley Food Delivery Driver Job at Waiter.com

 ...smile? Waiter.com, the Bay Area's leading Corporate Restaurant Delivery Service, is looking for delivery drivers for our Silicon Valley...  ...~ Health insurance ~401(k) with company match ~ Food discounts ~ Great team environment ~$100 hiring bonus after... 

Guardian Life

Data scientist Job at Guardian Life

 ...spearheads a culture of intelligence and automation across the enterprise, creating business value from advanced data and AI solutions. Our team includes data scientists, engineers, analysts, and product leaders working together to deliver AI-driven products that power growth... 

Illuminated Integration

Systems Integrator Job at Illuminated Integration

 ...About the Role The Systems Integrator is a critical technical role responsible for implementing, configuring, and commissioning integrated technology systems. This position works closely with designers, installers, and end users to ensure systems are delivered cleanly... 

Pratt Community College

Pratt Edukan Online Adjunct Faculty Position Job at Pratt Community College

 ...Job Description PRATT EDUKAN ONLINE ADJUNCT FACULTY~ Masters degree required. ~2+ years of online teaching experience required. ~ Courses Available:~ Technology ~ Chemistry ~ Medical / Biology ~ Philosophy / Ethics Apply online at or... 

Euronet Worldwide, Inc.

Global Event Manager Job at Euronet Worldwide, Inc.

 ...transactions across the globe. Are you passionate about creating seamless, memorable event experiences that drive business success? As a Global Event Manager at Euronet,youllplan and execute corporate meetings, trade shows, andspecial events from travel andlogistics...