Travel Case Manager

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Job Title: Travel Case Manager

Job Location- Miami Dade County, FL

Duration: 3+ Months (Possibility of extension)

Shift - M-F 8am- 5pm

Pay Rate - $34.11/Hour on W-2

**** Must put the city, state and zip code they reside in at top of resume. ****

Location: Work from Home. Candidates must reside in Miami Dade County, FL. 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.

Qualifications:
FLUENT 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'shealth 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

Provide comprehensive healthcare management services to facilitate appropriate healthcare
treatment, effectively manage healthcare costs and improve healthcare program/operational
efficiency involving clinical issues.
• Candidates must be located in mid Miami.
• This role will require 50-75% travel for face-to-face visits with members in Mid Miami area.
• Schedule is Monday-Friday, 8:00am-5:00pm, standard business hours

Preferred Qualifications:
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
• Effective communication skills, both verbal and written
• Managed Care experience
• Computer proficiency in Microsoft Word, Excel, and Outlook required
• Case management and discharge planning experience

Key Responsibilities

• Coordinate case management activities for Medicaid Long-Term Care/Comprehensive Program enrollees.
• Utilize critical thinking and clinical judgment to collaborate and support the case management process.
• Facilitate appropriate healthcare outcomes by providing care coordination, education, and member support using care management tools and resources.
• Conduct comprehensive member assessments using care management tools and data review.
• Coordinate, implement, and monitor individualized care plans.
• Conduct multidisciplinary reviews to achieve optimal healthcare outcomes.
• Identify and escalate quality of care concerns through established channels.
• Negotiate and coordinate appropriate services to meet members' healthcare and benefit needs.
• Utilize motivational interviewing and influencing techniques to maximize member engagement and promote healthy lifestyle changes.
• Provide education, coaching, and support to empower members to make informed healthcare decisions.
• Assist members in actively participating with healthcare providers regarding treatment planning and care decisions.
• Maintain accurate documentation and ensure compliance with case management standards, regulatory requirements, accreditation guidelines, and company policies.

Required Experience

Case management experience required
Long term care experience preferred
Microsoft Office including Excel competent

Education:

Bachelor's degree required - No nurses. Social work degree or related field preferred.