Healthcare Consultant I – Analyst, Case Management

• Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education for members using care management tools and resources.
• Conducts comprehensive evaluation of Members using care management tools and information/data review.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Conducts multidisciplinary review to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the members benefits and/or healthcare needs.
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgeably participate with their provider in healthcare decision-making.
• Monitoring, Evaluation and Documentation of Care.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements

• Bachelor’s degree or Associates degree in nursing.
• Active Registered Nurse License.
• Verifiable High School Diploma or GED Required.
• Must have Case Management.
• Possible experience in behavioral healthcare.
• Case management and discharge planning experience preferred.
• Managed Care experience preferred.
• Microsoft Office experience preferred.
• 2+ Years of clinical experience.

 

As an equal opportunity employer, ICONMA prides itself on creating an employment environment that supports and encourages the abilities of all persons regardless of race, color, gender, age, sexual orientation, citizenship, or disability.

Olivia Ojiaku
M: (248) 515-6856