Medicaid Care Coordination Specialist - Ohio

SGS Consulting; Columbus (OH); À distance; USD 52 000 - 65 000; Plein temps

Résumé du poste

SGS Consulting is seeking a Case Management Coordinator for a full-time, field-based telework role in Ohio. The position requires travel within Western Ohio to member homes and locations up to 50% or more, with residency in the west region of Ohio.

Typical hours are Monday–Friday, 8–5, with flexibility for additional time to meet member needs. The role supports OhioRISE: coordinating care, educating members, and collaborating with MCOs, vendors, and ODM to improve outcomes for children with

Qualifications

• Bachelor’s degree or non-licensed master level clinician in behavioral health, human services, health services, or public health.
• Experience in Medicaid is preferred.
• Focus on behavioral health and child-serving systems is desirable.

Responsabilités

• Be clinically and culturally competent with training to manage complex cases in the community.
• Evaluation of referred members’ needs and eligibility, and recommendations for case resolution.
• Coordinates and implements assigned care plan activities and monitors progress.
• Enhancement of medical appropriateness and quality of care through collaboration with care teams to overcome barriers.
• Works with the members’ Child and Family Teams and escalates quality of care issues when needed.
• Uses negotiation and motivational interviewing to secure appropriate options and promote engagement.
• Provides coaching and support to empower members to participate in care decisions and healthy lifestyle choices.
• Acts as a single point of contact to remediate gaps in care and access.
• Monitors, evaluates, and documents care per regulatory guidelines.

Connaissances

Case management

Discharge planning

Managed Care

Medicaid experience

Formation

Bachelor’s degree in Behavioral Health

Description du poste

SGS Consulting is seeking a Case Management Coordinator for a full-time, field-based telework role in Ohio. The position requires travel within Western Ohio to member homes and locations up to 50% or more, with residency in the west region of Ohio.

Typical hours are Monday–Friday, 8–5, with flexibility for additional time to meet member needs. The role supports OhioRISE: coordinating care, educating members, and collaborating with MCOs, vendors, and ODM to improve outcomes for children with