Case Management Coordinator

ICONMA; Miami (FL); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Health benefits

Referral program

Growth opportunities

Job summary

ICONMA is seeking a Case Management Coordinator for our client, a Retail Pharmacy in the Miami area, to coordinate Medicaid Long Term Care/Comprehensive Program enrollees' care.

The role requires 1 year of case management experience, bilingual Spanish/English, and proficiency in Microsoft Office. The candidate will develop and monitor care plans, educate members, and collaborate with providers to achieve optimal outcomes.

Qualifications

• One year case management experience required.
• Case Management Certificate preferred.
• Proficient in Microsoft Office including Excel.

Responsibilities

• Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Collaborates with care teams to inform the case management process and support members.
• Evaluates Members using care management tools and data.
• Coordinates and monitors care plan progress.
• Conducts multidisciplinary reviews to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.

Skills

Case management

Bilingual Spanish/English

Education

Bachelor's degree

Social work degree or related field preferred

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Our Client, a Retail Pharmacy company, is looking for a Case Management Coordinator for their MID Miami, FL (33172, 33174,33175 33144,33134,33184,33165,33183,33193,33182) location.

Responsibilities:

• 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.

Requirements:

• One year Case management experience A MUST
• Case Management Certificate (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
• Managed Care experience
• Computer proficiency in Microsoft Word, Excel, and Outlook required
• Case management and discharge planning experience
• Education:
• Bachelor's degree required - No nurses. Social work degree or related field preferred.

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities