Job Description
Title: Healthcare Consultant I - North Miami area
Location: (North Miami, Aventura, Hialeah or Miramar)
Shift: Mon-Fri 8am to 5pm
Duration: 3+ Months (Possibility of extension)
Pay rate: $34.11/hr
Location: Work from Home. Candidates must reside in North Miami, Aventura, Hialeah or Miramar.
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
Bilingual (English / Spanish) REQUIRED - must be Fluent speaking and writing.
Mileage reimbursement is approved to and from member homes.
Candidates must be located in North Miami Dade county
This role will require 50-75% travel for face-to-face visits with members in Miami Dade.
Schedule is Monday-Friday, 8:00am-5:00pm, standard business hours.
- We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team.
- This opportunity offers a competitive salary and full benefits. Our organization promotes autonomy through a Monday -Friday working schedule, paid holidays, 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 supports.
Position Summary
- Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs, and improve healthcare program and operational efficiency involving clinical issues.
Key Duties & Responsibilities
- Determine medical necessity and appropriateness of healthcare services
- Facilitate optimal patient outcomes through effective care coordination
- Identify, monitor, and follow through on continuous quality and compliance opportunities
- Recognize aberrances and initiate corrective actions as needed
- Educate and empower customers to ensure compliance, satisfaction, and promote patient advocacy
- Optimize total healthcare costs while maintaining quality standards
- Implement and evaluate policies based on utilization and program directives
- Educate and empower colleagues at all levels to support informed decision-making at the most appropriate level
Required Experience & Skills
- Case management experience required
- Long-term care experience preferred
- Proficiency in Microsoft Office applications, including Excel
Education Requirements
- Bachelor's degree required
- Degree in nursing, social work, or related clinical field not required
Job Tags
Temporary work, Work at office, Remote work, Work from home, Monday to Friday, Shift work,