RemoteDescription:We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. 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.DutiesDetermines medical necessity/ appropriatenessFacilitates optimal outcomesIdentifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective actionEducates/ empowers customers to ensure compliance, satisfaction and promote patient advocacyOptimize total costsImplementation and evaluation of policy based on usage and program directivesEducate/empower colleagues at all levels to enable decision making at most appropriate level ExperienceCase management experience requiredLong term care experience preferredMicrosoft Office including Excel competent Position SummaryProvide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues EducationBachelor's degree required-No nurse, social work degree or related field.Bilingual (English / Spanish) REQUIRED - must be Fluent speaking and writing.Notes:M-F: 8am-5pmThis role will require 50-75% travel for face-to-face visits with membersTraining will be conducted remotely via Microsoft Teams.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
Description:
We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Case Management Coordinator to join our Case Management team. 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.DutiesDetermines medical necessity/ appropriatenessFacilitates optimal outcomesIdentifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective actionEducates/ empowers customers to ensure compliance, satisfaction and promote patient advocacyOptimize total costsImplementation and evaluation of policy based on usage and program directivesEducate/empower colleagues at all levels to enable decision making at most appropriate level
ExperienceCase management experience requiredLong term care experience preferredMicrosoft Office including Excel competent
Position SummaryProvide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues
EducationBachelor's degree required-No nurse, social work degree or related field.
Bilingual (English / Spanish) REQUIRED - must be Fluent speaking and writing.Notes:M-F: 8am-5pm
This role will require 50-75% travel for face-to-face visits with members
Training will be conducted remotely via Microsoft Teams.
Candidate will travel approximately 75% of the time within the region seeing members at home, in assisted living facilities and nursing homes
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