Job Title: Healthcare Consultant I Address: Miami, FL Schedule: M–F, 8:00am – 5:00pm, Full Time Job Description Coordinate case management activities for Medicaid Long Term Care/Comprehensive Program enrollees. Utilize critical thinking and judgment to inform the case management process and facilitate appropriate healthcare outcomes. Conduct comprehensive evaluations of members using care management tools and information/data review. Implement assigned care plan activities and monitor care plan progress. Conduct multidisciplinary reviews to achieve optimal outcomes. Identify and escalate quality of care issues through established channels. Utilize negotiation skills to secure appropriate options and services necessary to meet member benefits and healthcare needs. Utilize motivational interviewing skills to ensure maximum member engagement and promote lifestyle changes. Provide coaching and support to empower members to make independent medical and lifestyle choices. Help members actively participate in healthcare decision-making. Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines. Critical Information This role will require 50-75% travel for face-to-face visits with members. Must be fluent in speaking Spanish and able to have full conversations. Candidates must reside in Miami-Dade County, FL (preferred zip codes: 33010, 33012, 33013). Fully remote position, with training 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. Education/Licenses Needed High School Diploma or GED required. Bachelor's degree required - no nursing or social work degree. Case management experience required; long term care experience preferred. Benefits: Benefits are available to full-time employees after 90 days of employment. A 401(k) with a company match is available to full-time employees after 1 year of service on our eligibility dates. This is an AI-Formatted job description; therefore, this does not remove human decision-making. A-Line Staffing Solutions
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