Healthcare Consultant II

4 weeks ago


Springfield, United States US Tech Solutions, Inc. Full time
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 aberrance's 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 aberrance's 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               
  • Minimum 2 years of relevant experience  
Education           
  • Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required
Skills:   
  • Case management, Behavioral health, social services, Travel

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