Healthcare Consultant I SW Ohio
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Job Location:
Columbus, NE - USA
Monthly Salary:
Not Disclosed
Posted on:
8 days ago
Vacancies:
1 Vacancy
Job Summary
Here are the job details for your review:
Job Title: Healthcare Consultant (Case Management)
Job Location: South West Ohio
Duration: 6 Months Contract (Potential for extension)
Shift : Mon-Fri 8-5
Payrate: $29.77/hr on W2
Candidates must reside in one of these counties:
SW OHIO Counties: Adams Allen Auglaize Brown Butler Champaign Clark Clermont Clinton Darke Defiance Fulton Greene Hamilton Hardin Henry Lawrence Logan Lucas Madison Mercer Miami Montgomery Paulding Preble Putnam Scioto Shelby Van Wert Warren Williams
Candidates could be required to travel to the corporate office in Franklin County for onsite meetings. These usually happen 1 2 times a year.
Job Description:
- This is a full-time field-based telework position in Ohio. This position requires the ability to travel within the assigned region of Southwest Ohio to member homes and other requested member locations up to 50% or more of the time.
- Applicants must reside within the Southwest region of Ohio: Adams Allen Auglaize Brown Butler Champaign Clark Clermont Clinton Darke Defiance Fulton Greene Hamilton Hardin Henry Lawrence Logan Lucas Madison Mercer Miami Montgomery Paulding Preble Putnam Scioto Shelby Van Wert Warren Williams.
- Monday-Friday 8-5pm with flexibility needed to work later to meet member needs.
Business Overview
As part of the bold vision to deliver the Next Generation of managed care in Ohio Medicaid OhioRISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs vendors and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in or at risk for involvement in multiple child-serving systems.
The Case Management Coordinator 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. Must reside in Ohio.
Fundamental Components:
Be clinically and culturally competent/responsive with training and experience necessary to manage complex cases in the community across child-serving systems.
Evaluation of Members:
- Through the use of care management tools and information/data review conducts comprehensive evaluation of referred members needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members benefit plan and available internal and external programs/services.
- Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
- Coordinates and implements assigned care plan activities and monitors care plan progress.
Enhancement of Medical Appropriateness and Quality of Care:
- Using holistic approach consults with case managers supervisors Medical Directors and/or other health/behavioral health programs to overcome barriers to meeting goals and objectives.
- Presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
- Works collaboratively with the members Child and Family Teams.
- 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.
- Serves as a single point of contact for members and assists members to remediate immediate and acute gaps in care and access.
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.
Required Qualifications
- Bachelors degree or non-licensed master level clinician required
- 2 years of experience in behavioral health social services or human services
- 2 years of experience with personal computers keyboard and multi-system navigation and MS Office Suite applications (Outlook Word Excel SharePoint)
- 2 years of experience in childrens mental health child welfare developmental disabilities juvenile justice or a public sector human services or behavioral health care field providing community-based services to children and youth and their family/caregivers
- 2 years experience in one or more of the following areas of expertise: family systems community systems and resources case management child and family counseling/therapy child protection or child development
- 2 years of experience with Ohio delivery systems including local community networks and resources
- Willing and able to travel within the assigned region up to 50% of the time; some travel to the New Albany (Franklin County) office may be required for trainings/meetings
- Reliable transportation required
- Mileage is reimbursed per company expense reimbursement policy
- Willing and able to work beyond core business hours of Monday-Friday 8am 5pm as needed
Education
- Bachelors degree or non-licensed master level clinician required with either degree being in behavioral health human services health services or public health preferred (i.e. psychology social work marriage and family therapy counseling juvenile justice).
Preferred Qualifications
- Case management and discharge planning experience
- Managed Care experience
- Medicaid experience
