Analyst – Case Management – Field

Analyst – Case Management – Field

Requirements

• Bilingual in Spanish and English
• Must reside in Polk County FL or Surrounding Areas
• Willing and able to travel 50-75% of their time to meet members face to face in Polk County and surrounding areas in FL
• 1 + year of experience in behavioral health or a long-term care setting

Responsibilities

• Effectively manage a caseload that includes supportive and medically complex members
• Utilize critical thinking and judgment to collaborate and inform the case management process
• Facilitate appropriate healthcare outcomes for members by providing care coordination, support and education
• Conduct comprehensive evaluation of Members using care management tools and information/data review
• Coordinate and implement assigned care plan activities and monitor care plan progress
• Conduct multidisciplinary review in order to achieve optimal outcomes
• Identify and escalate quality of care issues through established channels
• Utilize negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
• Utilize influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health

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 Microsoft Word, Excel, and Outlook required
• Case management and discharge planning experience