Verum Technical Staffing
http://cdn.haleymarketing.com/templates/62326/logos/200x200.png
http://www.verumtechnical.com
http://www.verumtechnical.com
USD
43
43
HOUR
true
Here are the job details for your review:
Job Title: Healthcare Consultant II
Client Name: CVS Health/Aetna
Job Location: Field, Topeka, KS, USA, 66603
Duration 5 months (possibility to extension)
Pay Rate: $43.74/HR on W2
Shift Timings: Mon - Fri 8:00 - 5:00 – CST
LOCATION NEEDED WILL BE:
1. Sedgwick
2. Butler
Description:
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues.
Roles and Responsibilities:
- Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's 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 programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order 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 knowledgably 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:
1+ year(s) behavioral health, social services, or human services field.
-Willing and able to travel up to 50%-75% locally to meet members face to face
- Must have reliable transportation.
Preferred Qualifications:
- Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel is strongly preferred.
- Case management and discharge planning experience preferred
- Managed Care experience preferred
-1-year Experience in Home and Community based services (HCBS) waiver.
Education:
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, rehabilitation, social work, marriage and family therapy, counseling).
*Healthcare Consultant II - Kansas (Sedgwick, Butler & Surrounding Counties
Topeka, KS 66612 United States
Posted: 08/02/2024
2024-08-02
2024-10-20
Job Number: z5G7h3l6a1kMvyS65NP3c4dYDOx0w7Iz5xJJ4sIB1b8=
Pay Rate: 43-43 Hourly USD
Job Description
Here are the job details for your review:
Job Title: Healthcare Consultant II
Client Name: CVS Health/Aetna
Job Location: Field, Topeka, KS, USA, 66603
Duration 5 months (possibility to extension)
Pay Rate: $43.74/HR on W2
Shift Timings: Mon - Fri 8:00 - 5:00 – CST
LOCATION NEEDED WILL BE:
1. Sedgwick
2. Butler
Description:
Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues.
Roles and Responsibilities:
- Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's 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 programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order 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 knowledgably 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:
1+ year(s) behavioral health, social services, or human services field.
-Willing and able to travel up to 50%-75% locally to meet members face to face
- Must have reliable transportation.
Preferred Qualifications:
- Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel is strongly preferred.
- Case management and discharge planning experience preferred
- Managed Care experience preferred
-1-year Experience in Home and Community based services (HCBS) waiver.
Education:
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, rehabilitation, social work, marriage and family therapy, counseling).
Related Jobs:
Login to save this search and get notified of similar positions.About Topeka, KS
Ready for your next career move in Topeka, Kansas? Discover exciting job opportunities in this vibrant city that blends small-town charm with big-city amenities. Known for its rich history, Topeka offers a thriving job market, affordable living costs, and a welcoming community. Dive into the world-renowned Topeka Performing Arts Center, explore the stunning artworks at the Mulvane Art Museum, or catch a show at the Topeka Civic Theatre. Indulge in local favorites like Kansas City-style barbecue or unwind in the beauty of Lake Shawnee Park. Join us in Topeka and unlock a world of career possibilities and unforgettable experiences!