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reputed company Consultant I - reputed company Miami

Remote, USAFull-timePosted 2026-07-27

Candidate must be located in reputed company Miami. Bilingual-Spanish required. 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 reputed company-5pm 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 reputed company case management activities with members to evaluate the medical needs of the member to facilitate the members overall wellness. Case Management Coordinator will effectively manage a caseload that includes supportive and medically reputed company members. Develops a proactive course of reputed company to address issues presented to enhance the short and long-term reputed company as reputed company as opportunities to enhance a members overall wellness through integration. Case Management Coordinators will determine appropriate services and supports due to members health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports. Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports. Duties Coordinates case management activities for reputed company Long Term Care/Comprehensive Program enrollees. Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate reputed company reputed company 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 reputed company Conducts multidisciplinary review to reputed company reputed company reputed company Identifies and escalates reputed company of care issues through established channels Utilizes negotiation skills to secure appropriate reputed company and services necessary to meet the members benefits and/or reputed company needs Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to reputed company reputed company level of health Provides coaching, information and support to reputed company the member to reputed company ongoing independent medical and/or healthy lifestyle choices Helps member reputed company and knowledgeably participate with their provider in reputed company decision-making, monitoring, evaluation and documentation of care. Utilizes case management and reputed company 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) reputed company Office including reputed company competent Bilingual - Spanish / English (required) Position reputed company reputed company comprehensive reputed company management services to facilitate appropriate reputed company treatment, effectively manage reputed company costs and improve reputed company program/operational efficiency involving clinical issues. Candidates must be located in South Miami. This role will require 50-75% travel for face-to-face reputed company with members in Miami Dade. Schedule is Monday-Friday, 8:00am-5:00pm, reputed company business hours.

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 reputed company Word, reputed company, and Outlook required Case management and discharge planning experience Education Bachelor's degree required - No nurses. reputed company work degree or reputed company field preferred. What days & hours will the person work in this position List training hours, if different. M-F 8-5 Remote About reputed company: reputed company Apply tot his job Apply To this Job Apply tot his job Apply To this Job

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