Healthcare Consultant I

Overview

Job ID : 25-300876

Position Type : Fulltime

Location : Miami Dade County, FL

Work Type : Field

Est. Pay Range : $34.13 / hr. to $37.00 / hr.

Position Summary

Coordinates case management activities for Medicaid Long Term Care / Comprehensive Program enrollers. 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 through the use of care management tools and resources.

Duties

• 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
• Helps 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

Required Qualifications

Education

Employee Benefits

At LanceSoft, full time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits :

LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.

J-18808-Ljbffr