Local Contract Social Work - Clinic Social Worker
Miami Dade, FL
Apidel Technologies
5x8 hrs, Days
Referral Bonus

***This is a Local Contract job in Miami Dade, FL ***** No Travel worker will be considered.
Job Description
Position: Healthcare Consultant
Location: Miami Dade County, North Miami, Aventura, Hialeah or Miramar.
Duration: 03+ Months with possible extension
Shift: M-F; 8am- 5pm
Note:
Training will be conducted remotely via Microsoft Teams for approximately 1-2 weeks.
Candidate will travel approximately 75% of the time within the region seeing Members at home, in assisted living facilities and nursing homes.
Telephonic and site visits.
Mileage is reimbursed to and from member homes.
Bilingual Spanish/English
Duties
• Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Case Management Coordinator is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness.
• Case Management Coordinator will effectively manage a caseload that includes supportive and medically complex members.
• Develops a proactive course of action to address issues presented to enhance the short and Long term outcomes as well as opportunities to enhance a member's overall wellness through integration.
• Case Management Coordinators will determine appropriate services and supports due to member's health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.
• 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 through the use of care management t 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 member’s 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..
Experience
• Case management experience required
• Long term care experience preferred
• Microsoft Office including Excel competent.
Education
• Bachelor's degree required- No Nurses. Social work degree or related field.