Healthcare Consultant I

Job Description

Duties & Responsibilities:

• 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.

Experience & Education:

• Case Management experience required.
• Long Term Care experience preferred.
• Microsoft Office experience required: Excel, Teams, Outlook.
• Bachelor’s degree in social work or related field required. No Nurses.

Skills & Abilities :

• Training will be conducted remotely via Microsoft Teams.
• Bilingual (Spanish, English) FLUENT speaking and writing.
  Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment.
  Effective communication skills, both verbal and written.