Healthcare Consultant II

2 months ago


Topeka, Kansas, United States Umanist Staffing LLC Full time
Job Description

Umanist Staffing LLC is seeking a skilled Healthcare Consultant II - Telehealth Specialist to join our team. As a key member of our organization, you will play a critical role in developing and implementing effective health services strategies, policies, and programs that drive quality healthcare delivery and establish a competitive business advantage for our clients.

Key Responsibilities:
  • Evaluation of Members: Conduct comprehensive evaluations of referred members' needs and eligibility using care management tools and information/data review.
  • Case Resolution and Planning: Recommend approaches to case resolution and/or meeting needs by evaluating members' benefit plans and available internal and external programs/services.
  • Care Coordination and Monitoring: Coordinate and implement assigned care plan activities and monitor care plan progress.
  • Enhancement of Medical Appropriateness and Quality of Care: Consult with case managers, supervisors, Medical Directors, and/or other health programs to overcome barriers to meeting goals and objectives using a holistic approach.
  • Quality of Care Issues: Identify and escalate quality of care issues through established channels.
  • Member Engagement and Education: Utilize negotiation skills to secure appropriate options and services necessary to meet members' benefits and/or healthcare needs.
  • Coaching and Support: Provide coaching, information, and support to empower members to make ongoing independent medical and/or healthy lifestyle choices.
  • Healthcare Decision-Making: Help members actively and knowledgeably participate with their providers in healthcare decision-making.
  • Care Management and Quality Management: Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Requirements:
  • Experience: 1 year(s) in behavioral health, social services, or human services field.
  • Travel and Transportation: Willing and able to travel up to 50%-75% locally to meet members face-to-face. Must have reliable transportation.
Preferred Qualifications:
  • Computer Literacy: Computer literacy and demonstrated proficiency in navigating through internal/external computer systems.
  • MS Office Suite: Proficiency in MS Office Suite applications, including Word and Excel, is strongly preferred.
  • Case Management Experience: Case management and discharge planning experience preferred.
  • Managed Care Experience: Managed Care experience preferred.
  • HCBS Waiver Experience: 1-year experience in Home and Community-Based Services (HCBS) waiver.
Education:
  • Bachelor's Degree or Non-Licensed Master Level Clinician: Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, rehabilitation, social work, marriage and family therapy, counseling).

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