Healthcare Strategy Consultant II

2 weeks ago

Topeka, Kansas, United States Impresiv Health Full time
Position: Healthcare Consultant II

Location Requirement: Must be situated in a designated area.

Work Schedule: Monday to Friday, 8 AM to 5 PM.

Role Overview:
The Healthcare Consultant II is responsible for delivering extensive healthcare management solutions aimed at ensuring suitable healthcare interventions, effectively controlling healthcare expenditures, and enhancing operational efficiency within healthcare programs, particularly concerning clinical matters.

Key Responsibilities:
  • Conduct assessments of members utilizing care management tools and reviewing pertinent data, performing thorough evaluations of referred members' requirements and eligibility, and proposing strategies for case resolution and needs fulfillment by analyzing members' benefit plans and available services.
  • Recognize high-risk factors and service requirements that could influence member outcomes and care planning, facilitating appropriate referrals to clinical case management or crisis intervention when necessary.
  • Coordinate and execute designated care plan activities while monitoring the progress of care plans. Enhance medical appropriateness and quality of care through a holistic approach by collaborating with case managers, supervisors, Medical Directors, and other health programs to address barriers to achieving goals; present cases during case conferences for multidisciplinary reviews to secure optimal outcomes.
  • Identify and escalate quality of care concerns through established protocols.
  • Employ negotiation skills to secure necessary options and services that align with the member's benefits and healthcare requirements.
  • Utilize motivational interviewing techniques to maximize member engagement and encourage lifestyle changes that promote optimal health.
  • Provide guidance, information, and support to empower members in making informed, independent medical and lifestyle choices.
  • Assist members in actively participating in healthcare decision-making alongside their providers.
  • Monitor, evaluate, and document care using case management and quality management processes in compliance with regulatory and accreditation standards, as well as company policies.


Success Factors:
  • Experience in clinical support roles.
  • A minimum of 2 years in a managed care pharmacy setting.
  • Must operate within the Eastern Time zone.

Qualifications:
  • At least 1 year of experience in behavioral health, social services, or a related field.
  • Willingness to travel locally up to 50%-75% to meet members in person.
  • Reliable transportation is essential.
  • Proficiency in computer skills is required to navigate internal and external systems, with strong preference for experience in MS Office Suite applications, including Word and Excel.
  • Preferred experience in case management and discharge planning.
  • Managed care experience is advantageous.
  • 1 year of experience in Home and Community-Based Services (HCBS) waiver is preferred.
  • A Bachelor's degree or a non-licensed master's level qualification in behavioral health or human services is required (fields such as psychology, rehabilitation, social work, marriage and family therapy, or counseling are preferred).

About Impresiv Health:

Impresiv Health is a consulting partner in the healthcare sector, specializing in clinical and operational management, enterprise project management, professional services, and software consulting. We assist our clients in enhancing operational efficiency by providing innovative solutions to address their most intricate business challenges.

Our philosophy is straightforward: first, think and act like the clients who depend on us, and most importantly, deliver what larger organizations cannot – tangible results that add immediate value at an unmatched rate. Your success is our priority, and we are committed to it.

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