*Healthcare Consultant I - Miami-Dade County, FL (Hialeah)

Here are the job details for your review:  Job Title: Travel Case ManagerJob Location- Hialeah, FLDuration: 3+ Months Contract (Potential for extension)Pay Rate: $34.11/HR on W2Shift: Monday- Friday: 8 am- 5 pm ESTThis role will require 50-75% travel for face-to-face visits with members in the Hialeah (Must be in 33010, 33012, 33013, 33014, 33015, 33016, 33018) area of Miami-Dade County, FL. Mileage is reimbursable DO NOT CROSS SUBMIT CANDIDATES FOR SOUTH FLORIDA POSTINGS. MUST BE FLUENT IN ENGLISH AND SPANISH MUST RESIDE IN ONE OF THE ZIP CODES BELOW ADD CITY STATE AND ZIP AT TOP OF RESUME We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team in the Hialeah (33010, 33012, 33013, 33014, 33015, 33016, 33018) area of Miami-Dade County, FL Our organization promotes autonomy through a Monday- Friday, 8:00AM- 5:00PM 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 supportsDuties

• Coordinate case management activities for Medicaid Long Term Care / Comprehensive Program members*
• Use critical thinking and judgment to support care coordination and healthcare decision-making*
• Conduct comprehensive member assessments using care management tools and data review*
• Develop, implement, and monitor care plans to ensure progress toward health goals*
• Collaborate with multidisciplinary teams to achieve optimal outcomes*
• Identify and escalate quality of care issues through established channels*
• Negotiate services and resources to meet member healthcare and benefit needs*
• Apply motivational interviewing techniques to improve member engagement and promote behavior change*
• Educate, coach, and support members to make informed healthcare and lifestyle decisions*
• Ensure accurate monitoring, evaluation, and documentation in compliance with regulatory and company standards*

Preferred Qualifications

• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment*
• Effective communication skills, both verbal and written*
• Managed Care experience*
• Computer proficiency in Microsoft Word, Excel, and Outlook required*
• Case management and discharge planning experience*

Experience

• Case Management experience required*
• Long Term Care experience preferred*
• Proficiency in Microsoft Office (Excel, Teams, Outlook)*

Education-Bachelors degree required. No nurses. Social work degree or related field.