Qualifications: Bilingual Spanish/English REQUIRED (both reading and speaking and writing) Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Effective communication skills, both verbal and written
We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. Our organization promotes autonomy through a Monday-Friday working schedule and flexibility as you coordinate the care of your members.
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.
Position Summary: Location: Work from Home. Candidates must reside in Miami Dade County, FL (specifically Doral, Coral Gables). Training will be conducted remotely via Microsoft Teams for approximately 4-6 weeks. Candidate will travel approximately 75% of the time within the region seeing Members at home, in assisted living facilities and nursing homes.
Preferred Qualifications: Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Effective communication skills, both verbal and written
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 Education: Bachelors degree required - No nurses. Social work degree or related field.
...Dishwasher - Airport Lounge at Charlotte Douglas International Airport Join our team and receive a $200 sign-on bonus! Pay Rate: $19.00 per hour Schedule: 5:00 AM-1:00 PM Monday-Friday Dishwasher Job Description The work of Airport Lounge Dishwasher includes...
...Traffic Signal Systems Engineer Serves as a senior technical resource for the operation, coordination, and optimization of traffic signal systems supporting light rail and roadway networks. Ensures safe and efficient transportation operations through signal timing strategies...
...needs, overcome barriers and connect to opportunities.In partnership with the Director of Development and Communications, the Grant Manager supports the mission and goals of MCC through effective grants management. The Grant Manager is responsible for researching, preparing...
At Expedia Group, we help travelers explore the world, one journey at a time. As a global travel company powered by passionate people, trusted partnerships, and leading technology, we connect travelers, partners, and advertisers through our consumer brands, B2B network,...
...Job Description Job Description ABOUT US Edgemine is a leading womens fashion company based in Los Angeles, designing and manufacturing contemporary apparel for major retailers and brands. With a global production network and multiple brands under our umbrella,...