Job Description

Healthcare Consultant

Duration: 5+ Months Contract (Potential for extension)

Location: Citrus Park or Carolwood area (Florida)

Pay Rate: $37.39/ HR on W2

Shift Hours: M-F 8am-5pm EST

Case Management Coordinator (travel and remote work) Looking for candidates who are located in Citrus Park or Carolwood area (Florida). Candidates must reside in Hillsborough County, FL and live within 2-3 miles of the 33624/33625 zip code.

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 members 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 members overall wellness through integration.

Case Management Coordinators will determine appropriate services and supports due to members health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.

Experience: Case management experience required Long term care experience preferred Strong in Microsoft Office including Excel

Location: Work from Home. Candidates must reside in Hillsborough County, FL and live within 2-3 miles of the 33624/33625 zip code. 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.

REQUIRED Qualifications: Bilingual Spanish/English 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. Needs to be Social work degree or related field.

Qualification Additional Details 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 members 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.

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