Additional Details
Qualification Assessment Must Have
Verifyable High School Diploma or GED Required
Yes Duties
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, in order 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.
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 member to make ongoing independent medical and/or healthy lifestyle choices
Helps member 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.
Experience
Case management experience required
Long Term Care Experience Preferred
Microsoft Office including Excel competent
Position Summary
Location: Work from Home. Candidates must reside in Miami Dade County, FL.
Training will be conducted remotely via Microsoft Teams for approximately 1-2 weeks.
Candidate will travel approximately 75% of the time within the region seeing
Members at home, in assisted living facilities and nursing home Preferred Qualifications:
Bilingual Spanish/English
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Effective communication skills, both verbal and written
Education
Bachelor’s degree required. No nurses. Social work degree or related field.
What days & hours will the person work in this position? List training hours, if different.
M-F: 8am-5pm
Type of Start
Individual starts
As a Remote Wellness Specialist, you will be responsible for creating customized wellness-focused travel itineraries for our clients. This role...
Apply For This JobJoin a dynamic team as a Project Manager within our organization’s Project Management Office (PMO). ing directly to the Director...
Apply For This JobWe are currently seeking enthusiastic individuals to join our team as Remote Scheduling Coordinators. This is a unique opportunity to...
Apply For This JobFull Job Description Our growing practice is ready to add another great staff member to our team. We are looking...
Apply For This JobFull Job Description An exceptional person is needed to join our team. If you feel bored and unappreciated with your...
Apply For This JobCaritas are recruiting for Care Support Workers to join their client, a large care provider delivering dedicated and individually driven...
Apply For This Job