Healthcare Consultant I - Melbourne or Palm Bay, FL area Job at SGS Consulting, Florida

KzhEVkZzdlZ5eWxlVVFoWWNLeUc2M256dXc9PQ==
  • SGS Consulting
  • Florida

Job Description

Job Responsibilities:

  • 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, 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
  • Help 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:

  • Bilingual Spanish/English (not required but preferred)
  • 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

Axel Services Inc

Drywall Repair Technician - Drywall Finisher/Taper Job at Axel Services Inc

1+ years of drywall finishing or repairs REQUIRED Looking for an experienced drywall finisher to do small-to-medium-sized residential and commercial repairs, new and remodel finish jobs, and painting. We are a growing business serving customers in La Crosse, Eau Claire... 

HamiltonFultonMontgomery BOCES

Regional Summer School Health Teacher Job at HamiltonFultonMontgomery BOCES

 ...HFM BOCES Regional Summer School has an anticipated vacancy for a Health Teacher working remotely. Teacher preparation will be July 7 to July 9, 2026. The instructional responsibilities are dependent upon enrollment, up to 6 hours of prep time will be granted each... 

Confidential

Production Technician | Night Shift Job at Confidential

 ...Privately owned construction company in E.TN has immediate opening for a Project Manager. The ideal Project Manager will have a background in civil or vertical construction. Will be responsible for planning, coordinating, and implementing projects within the decided... 

Webconnex LLC

Junior Sales BDR Job at Webconnex LLC

 ...experiences~Participation in 3 company trips (including tropical summer experience with company & families)~10 vacation days (15...  ..., sporting events, exhibitions, and more. Through your outbound sales efforts, you'll be working alongside independent event organizers... 

Blue Frog Roofing

Traveling Roofer -Sheet Metal and Wall Panels - Federal/Military installations Job at Blue Frog Roofing

 ...wall systemssuch as metal panels, custom facades, and claddingwhile ensuring buildings are weatherproof. Given the requirement for roofing experience , this role specifically focuses on candidates who can manage complex transitions between walls and rooflines, apply...