Healthcare Consultant - Citrus Park Area at Conflux Systems

Remote, USA Full-time
Position: *Healthcare Consultant I - Citrus Park Area at Conflux Systems Healthcare Consultant I – Citrus Park Area Job at Conflux Systems, Florida Job Title: Healthcare Consultant Duration: 5+ Months Contract (Potential for extension) Location: Citrus Park or Carolwood area (Florida) Pay Rate: $37.39/hr on W2 Shift Hours: M-F 8am-5pm EST Job Description: We are seeking a self‑motivated, energetic, detail‑oriented, highly organized, tech‑savvy Case Management Coordinator to join our Case Management team. Case Management Coordinator responsibilities include telephonic and/or face‑to‑face assessment, planning, implementation, and coordination of all case management activities with members. The coordinator manages a caseload that includes supportive and medically complex members, develops proactive courses of action, determines appropriate services and supports, and facilitates overall wellness. Key Duties: • Coordinate case management activities for Medicaid Long Term Care/Comprehensive Program enrollees. • Utilize critical thinking and judgment to collaborate and inform the case management process, facilitating appropriate healthcare outcomes. • Conduct comprehensive evaluation of members using care management tools and data review. • Implement assigned care plan activities and monitor care plan progress. • Conduct multidisciplinary review to achieve optimal outcomes. • Identify and escalates quality of care issues through established channels. • Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs. • Use motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes. • Provide coaching, information, and support to empower members to make ongoing independent medical and/or healthy lifestyle choices. • Help members actively and knowledgeably participate with their provider in healthcare decision-making. • Monitor, evaluate, and document care using case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Required Qualifications: • Bilingual Spanish/English proficiency. • Ability to multitask, prioritize, and adapt effectively to a fast‑paced changing environment. • Effective communication skills, both verbal and written. • Experience in case management (required) with long‑term care experience preferred. • Strong proficiency in Microsoft Office, especially Excel. • Minimum Bachelor's degree in Social Work or related field (No nurse). Location & Work: Work from home, candidates must reside in Hillsborough County, FL and be within 2‑3 miles of ZIP codes 33624/33625. Training will be conducted remotely via Microsoft Teams. Candidates will travel approximately 75% of the time within the region, seeing members at home, in assisted living facilities, and nursing homes. #J-18808-Ljbffr Apply tot his job
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