Healthcare Consultant (Remote)

Schedule : Mon-Fri 8:00-5:00 EST

Description:

• NO INTERVIEW: THIS WILL BE MANAGER QUICK HIRE AFTER VIEWING THE RESUMES.
• Important Skills: Must be proficient with MS Office - with excel, should be comfortable using filters to sort through spreadsheet data.
• Outbound call experience is a major plus as these hires will be primarily on outbound calls with members.

Duties

• Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues
• Determines medical necessity/ appropriateness
• Facilitates optimal outcomes Identifies and follow through with continuous quality/ compliance opportunities . May also include identification of aberrance's and initiation of corrective action
• Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy
• Optimize total costs Implementation and evaluation of policy based on usage and program directives
• Educate/empower colleagues at all levels to enable decision making at most appropriate level.

Experience : ? Minimum 1 year of relevant experience

Position Summary : Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues

Education : High School Diploma/GED