*Healthcare Consultant I - North Miami area

Job description:
Job Title: Healthcare Consultant I - North Miami
Location: North Miami, Aventura, Hialeah or Miramar.
Candidates MUST reside in North Miami, Aventura, Hialeah or Miramar.
Schedule: Monday - Friday, 8:00am - 5:00pm (Standard Business Hours)
Job Type: Full-Time
Job Overview:
We are seeking a self-motivated, energetic, detail-oriented, and highly organized Case Management Coordinator to join our team. This position offers a flexible and autonomous work schedule, including paid holidays and the opportunity to make a meaningful impact on the health and wellness of our members. The Case Management Coordinator will be responsible for assessing, planning, implementing, and coordinating case management activities for a caseload of members, including those with complex medical needs. This role requires 50-75% travel within Miami Dade County and surrounding areas.
Key Responsibilities:

• Assess and Manage Caseload: Telephonically and/or face-to-face assessment, planning, implementation, and coordination of case management activities for members with a focus on enhancing overall wellness.
• Member Care Coordination: Collaborate with Primary Care Physicians (PCPs), skilled providers, and community resources to determine appropriate services and supports based on the member's health needs.
• Develop Action Plans: Create proactive courses of action to address medical issues and enhance short- and long-term health outcomes.
• Prior Authorizations and Medication Review: Ensure prior authorizations are obtained, perform medication reviews, and provide condition management information.
• Community Resource Coordination: Connect members with relevant community resources and support services to ensure comprehensive care.

Required Qualifications:

• Location: Candidates must be located in Miami Dade County.
• Bilingual: Fluent in English and Spanish.
• Travel: Willing and able to travel 50-75% of the time for face-to-face visits with members in Miami Dade County and surrounding areas.
• Experience: 1+ year of experience in behavioral health or long-term care settings.
• Education: Bachelor’s degree in Social Work or a related field required (No nurses).
• Skills: Proficiency in Microsoft Word, Excel, and Outlook.

Preferred Qualifications:

• Multitasking & Adaptability: Ability to multitask, prioritize, and adapt effectively in a fast-paced environment.
• Communication Skills: Strong verbal and written communication skills.
• Managed Care Experience: Experience in managed care settings.
• Case Management & Discharge Planning: Prior experience in case management and discharge planning.