Healthcare Consultant III

Job Description

Job Summary:

• Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues.

Duties & Responsibilities:

• Determines medical necessity/ appropriateness.
• Facilitates optimal outcomes.
• Identifies and follow through with continuous quality/ compliance opportunities .
• May also include identification of aberrance’s and initiation of corrective action.
• Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy.
• Optimize total costs.
• Implementation and evaluation of policy based on usage and program directives.
• Educate/empower colleagues at all levels to enable decision making at most appropriate level.

Required Education & Experience:

• Bachelor’s degree Required or non-licensed master-level clinician, with degree being in behavioral health or human services.
• Psychology, social work, marriage and family therapy, nursing, counseling, etc.
• Minimum 5 years of relevant experience.