Healthcare Consultant I - NE Ohio (Travel)

Job Responsibilities:

• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health/behavioral health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes.
• Works collaboratively with the members' Child and Family Teams.
• 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 members actively and knowledgably participate with their provider in healthcare decision-making. Serves a single point of contact for members and assist members to remediate immediate and acute gaps in care and access.
• 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.

Skills:

• Bachelor’s degree or non-licensed master level clinician required
• 02+ years of experience in behavioral health, social services, or human services
• 02+ years of experience with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint).
• 02+ years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or a public sector human services or behavioral health care field, providing community-based services to children and youth, and their family/caregivers.
• 02+ years’ experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development.
• 02+ years of experience with Ohio delivery systems, including local community networks and resources.
• Willing and able to travel within the assigned region up to 50% of the time; Some trip to the New Albany office may be required for training/meetings:
• Reliable transportation required
• Mileage is reimbursed per our company expense reimbursement policy
• Case management and discharge planning experience.
• Managed Care experience.
• Medicaid experience.

Education/Experience:

• Bachelor’s degree or non-licensed master level clinician required, with either degree being in behavioral health, human services, health services, or public health preferred. (i.e. psychology, social work, marriage and family therapy, counseling, juvenile justice)