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Skills
Case Managementunmatched
Certified Case Manager (CCM)unmatched
Coachingunmatched
Communication Skillsunmatched
Corporate Policiesunmatched
Documentationunmatched
English Languageunmatched
Establish Prioritiesunmatched
Health Planunmatched
Healthcareunmatched
Healthcare Providersunmatched
Long-Term Careunmatched
Maintain Complianceunmatched
Medicaidunmatched
Member Orientationunmatched
Microsoft Excelunmatched
Microsoft Officeunmatched
Multilingualunmatched
Multitaskingunmatched
Negotiation Skillsunmatched
Nursingunmatched
Organizational Skillsunmatched
Pharmacyunmatched
Presentation/Verbal Skillsunmatched
Quality Managementunmatched
Quality of Careunmatched
Regulatory Complianceunmatched
Retailunmatched
Social Workunmatched
Spanish Languageunmatched
Writing Skillsunmatched
Description
Our Client, a Retail Pharmacy company, is looking for a Case Management Coordinator for their Orange County, FL location.
Responsibilities:
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, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of 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 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
Requirements:
One year Case management experience A MUST / Case Management Certificate ( Preferred)
Long term care experience (Preferred)
Microsoft Office including Excel competent
Bilingual - Spanish / English (preferred)
Preferred Qualifications:
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Effective communication skills, both verbal and written
Education
Bachelor's degree required - No nurses. Social work degree or related field preferred.