Healthcare Consultant II - Kansas (Douglas,Shawnee, Riley & Surrounding)

Title: Healthcare Consultant II
 
Must Be Located in Douglas, Shawnee, or Riley County
 
Schedule: Monday-Friday 8am-5pm
 
Description:
The Healthcare Consultant II will provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively
manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues.
 
What You Will Do:
 

• Evaluation of Members using care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• 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 programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes.
• 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.
• Monitoring, Evaluation and Documentation of Care utilizing case management and quality management processes in compliance with regulatory and
  accreditation guidelines and company policies and procedures.

 
 
You Will Be Successful If:
 

• Have experience within clinical support.
• Minimum of 2 years of experience as a Pharmacy in a managed care setting
• Must work in Eastern Time zone.

 
What You Will Bring:
 

• 1+ year(s) experience within behavioral health, social services, or human services field.
• Willing and able to travel up to 50%-75% locally to meet members face to face
• Must have reliable transportation.
• Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel, is strongly preferred.
• Case management and discharge planning experience preferred.
• Managed Care experience preferred.
• 1-year Experience in Home and Community based services (HCBS) waiver preferred.
• Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral
  health or human services preferred (psychology, rehabilitation, social work, marriage, and family therapy,
  counseling).

 
About Impresiv Health:
 
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
 
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.
 
That’s Impresiv!