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Case Manager - Long Term Care
Job
Sgs Consulting
Orlando, FL (In Person)
Full-Time
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Job Description
Initial Contract for 3-4 Months with possibility of Extension or Full time Based on Performance and Client Need.
Candidates must be located in Miami-Dade County, FL.This role will require
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 reviewCoordinates and implements assigned care plan activities and monitors care plan progressConducts multidisciplinary review to achieve optimal outcomesIdentifies and escalates quality of care issues through established channelsUtilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needsUtilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of healthProvides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choicesHelps 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.
Social work degree or related field preferred.
What days & hours will the person work in this position?
List training hours, if different.
Monday-Friday 8am-5pm
Note :
Bilingual is Must inSpanishPosition Summary:
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues.Candidates must be located in Miami-Dade County, FL.This role will require
- % travel for face-to-face visits with members in Miami Dade.
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 reviewCoordinates and implements assigned care plan activities and monitors care plan progressConducts multidisciplinary review to achieve optimal outcomesIdentifies and escalates quality of care issues through established channelsUtilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needsUtilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of healthProvides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choicesHelps 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.
Experience:
One year Case management experience A MUST / Case Management Certificate (Preferred)- Long term care experience (Preferred)
- Microsoft Office including Excel competent
- Bilingual - Spanish / English (required)
Preferred Qualifications:
Ability to multitask, prioritize and effectively adapt to a fast-paced changing environmentEffective communication skills, both verbal and writtenManaged Care experienceComputer proficiency in Microsoft Word, Excel, and Outlook requiredCase management and discharge planning experienceEducation:
Bachelor's degree required - No nurses.Social work degree or related field preferred.
What days & hours will the person work in this position?
List training hours, if different.
Monday-Friday 8am-5pm