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Healthcare Consultant II
2 months ago
We are seeking a skilled Healthcare Consultant II to join our team at Integrated Resources, Inc. in Springfield, IL. As a key member of our healthcare team, you will be responsible for providing care coordination, support, and education to our waiver/LTSS members.
Key Responsibilities- Care Coordination: Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing comprehensive healthcare management services.
- Medical Necessity Determination: Determine medical necessity and appropriateness of healthcare services.
- Quality and Compliance: Identify and follow through with continuous quality and compliance opportunities.
- Aberrance Identification: Identify aberrances and initiate corrective action.
- Patient Advocacy: Educate and empower customers to ensure compliance, satisfaction, and promote patient advocacy.
- Cost Optimization: Optimize total costs by implementing and evaluating policy based on usage and program directives.
- Experience: Minimum of 2 years of experience in behavioral health or social services field or human services.
- Case Management: Must have 2+ years of experience in case management.
- Travel: Willing and able to travel using your own vehicle 50-75% of their time to meet with members face to face in north Chicago and surrounding areas.
- Education: Bachelor's degree in social services, human services, or behavioral health.