DutiesCoordinates 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 reviewCoordinates and implements assigned care plan activities and monitors care plan progressConducts multidisciplinary review to achieve optimal outcomesIdentifies and escalates quality of care issues through established channelsUtilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needsUtilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of healthProvides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choicesHelps member actively and knowledgeably participate with their provider in healthcare decision-makingMonitoring, Evaluation and Documentation of Care:Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.ExperienceCase management experience requiredLong term care experience preferredMicrosoft Office including Excel competentREQUIRED: FLUENT bilingual Spanish / EnglishPreferred Qualifications:Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentEffective communication skills, both verbal and writtenEducationBachelors degree required. No nurses. Social work degree or related field.Notes:M-F 8am-5pmLocation: Work from Home. Training will be conducted remotely via Microsoft Teams for approximately 1-2 weeks.Candidate will travel approximately 75% of the time within the region seeingMembers at home, in assisted living facilities and nursing homes.
At VIVA, employee well-being is paramount. Our comprehensive benefits package ensures your health, financial security, and quality of life are always prioritized.
VIVA provides employees access to a comprehensive group health insurance plan (Medical, Dental, Vision, Basic Life, Term Life, and Accidental Death) through our flexible PPO plan-allowing you the freedom to choose healthcare providers.
Plan securely for your future with automatic payroll deductions into a tax-advantaged 401(k) retirement plan, including employer-matching contributions for eligible employees.
Earn performance-based bonuses and generous referral incentives of up to $500 when recommending talented candidates who become part of the VIVA family.
Enjoy timely and convenient payroll with biweekly direct deposit to your chosen financial institution. Biweekly Direct Deposit
Access exclusive employee discounts and savings on electronics, travel, groceries, apparel, and more through our dedicated VIVA Perks Program.