Case Management Coordinator

VIVA USA Inc; Homestead (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

VIVA USA Inc. is seeking a self-motivated Case Management Coordinator to join our team in the Miami-Dade region, with 75% travel to visit members at home, assisted living facilities and nursing homes.

This role follows a Monday–Friday schedule (8:00am–5:00pm) with telephonic and face-to-face assessments and comprehensive care coordination. The ideal candidate has case management experience, preferably in long-term care, and is proficient with Microsoft Office and Excel.

Qualifications

• Bachelor's degree required; No Nurses.
• Case management experience required.
• Long term care experience preferred.
• Microsoft Office including Excel competent.

Responsibilities

• Coordinate case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Conduct comprehensive evaluation of Members and monitor care plan progress.
• Conduct multidisciplinary reviews to achieve optimal outcomes.
• Identify and escalate quality of care issues.
• Use negotiation and motivational interviewing to maximize engagement and outcomes.
• Provide coaching and support to empower informed health decisions.
• Document and monitor care per regulatory guidelines.

Skills

Case management

Microsoft Office

Excel

Communication

Care coordination

Education

Bachelor's degree

Social Work degree

Tools

Microsoft Teams

Job description

This role will require 75% travel for face-to-face visits with members in Miami Dade.

We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. Our organization promotes autonomy through a Monday -Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members. Case Management Coordinator is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Case Management Coordinator will effectively manage a caseload that includes supportive and medically complex members. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Case Management Coordinators will determine appropriate services and supports due to member's health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.

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

• Case management experience required
• Long term care experience preferred
• Microsoft Office including Excel competent

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

Notes:

• Telephonic and field visits.
• Schedule is Monday-Friday, 8:00am-5:00pm, standard business hours.
• Training will be conducted remotely via Microsoft Teams for approximately 4 weeks. Candidate will travel approximately 75% of the time within the region seeing Members at home, in assisted living facilities and nursing homes.

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