Healthcare Consultant III

Job Description

Job Summary:

• 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.
• 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.

Required Qualifications :

• Minimum 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention services or evidence-based practices applicable to the Kentucky SKY populations, is required.
• Minimum 2 year of experience required in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
• Minimum 1 year of experience in MS Office Suite applications, including Word and Excel.
• Willing and able to travel 80-90% of their time to meet members face to face in their assigned region.
• Candidate must reside in: Jefferson County.
• 3+ years’ experience required in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
• 1+ Client experience.

Education & Experience:

• Minimum of a Bachelor’s Master’s degree or a non-licensed master level clinician is required; with either degree being in behavioral health or a relevant human services field of study required (social work, psychology, marriage and family therapy.
• Minimum 5 years of relevant experience.