Healthcare Consultant II

2 weeks ago


Richmond, Virginia, United States Careerbuilder-US Full time

Job title : Healthcare Consultant II
Location: Richmond ,VA, 23223

Duration: 0-6 Months+

Shift: M-F 8-5 PM

Need candidates from Northern Richmond in areas like Henrico, Lakeside, Tuckahoe Counties.

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.

Determines medical necessity/ appropriateness Facilitates optimal outcomes Identifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrances and initiation of corrective action Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy Optimize total costs Implementation and evaluation of policy based on usage and program directives Educate/empower colleagues at all levels to enable decision making at most appropriate level

Duties:

  • Determines medical necessity/ appropriateness.
  • Facilitates optimal outcomes.
  • Identifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrances and initiation of corrective action.
  • Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy.
  • Optimize total costs.
  • Implementation and evaluation of policy based on usage and program directives.
  • Educate/empower colleagues at all levels to enable decision making at most appropriate level.

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