Bilingual Case Management Coordinator

VIVA USA Inc; Tampa (FL); On-site; USD 50,000 - 65,000; Full time

Job summary

VIVA USA Inc. is seeking a Bilingual Case Management Coordinator in the Tampa, FL area.

The role involves conducting telephonic and face-to-face assessments, developing and implementing care plans, and coordinating services to improve health outcomes for Medicaid enrollees. The ideal candidate will be fluent in Spanish and English, organized, and capable of managing multiple cases with strong communication skills.

Qualifications

• Bachelor's degree required.
• Fluent in English and Spanish.
• Experience in case management and healthcare coordination preferred.

Responsibilities

• Conducts telephonic and face-to-face assessments to develop care plans.
• Manages a caseload of Medicaid members and coordinates services.
• Obtains prior authorizations and collaborates with PCPs and specialists.
• Provides care coordination, education, and monitoring of plan progress.
• Travels to member homes and facilities 75% of the time.

Skills

Bilingual: Spanish/English

Case management

Communication skills

MS Office

Education

Bachelor's degree

Tools

Microsoft Office

Excel

Job description

Candidates MUST be located in Tampa FL zip codes (33604, 33614 or 33615)

We are seeking a self-motivated, energetic, detail-oriented, highly organized, and tech-savvy Bilingual (Spanish-English) Case Management Coordinator to join our Case Management team.

The Case Management Coordinator is responsible for conducting telephonic and/or face-to-face assessments, developing and implementing care plans, managing a caseload of supportive and medically complex members, and coordinating services to improve health outcomes and overall wellness. Responsibilities include obtaining prior authorizations, coordinating care with PCPs and specialty providers, providing condition management education, conducting medication reviews, and connecting members to community resources and support services. The ideal candidate possesses strong communication, organizational, and problem-solving skills and is committed to delivering high-quality, member-centered care.

Duties

• 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.

Experience

• One year Case management experience A MUST / Case Management Certificate ( Preferred)
• Long term care experience (Preferred)
• Microsoft Office including Excel competent
• Bilingual - Spanish / English (required)

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.

Training will be conducted remotely via Microsoft Teams.

Candidate will travel approximately 75% of the time within the region seeing Members at home, in assisted living facilities and nursing homes.

Notes

• Monday-Friday 8am-5pm.
• safety sensitive
• This role will require 75% travel for face-to-face visits with members.
• Schedule is Monday-Friday, 8:00am-5:00pm, standard business hours.
• Required to be FLUENT in English and Spanish

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status