About the job
As a Medicaid Case Manager, you will play a pivotal role in providing case coordination for Medicaid members. Your critical thinking and judgment will be essential in collaborating and informing the case management process. Your focus will be on facilitating optimal healthcare outcomes for members by offering care coordination, support, and education through effective use of care management tools and resources.
Key Responsibilities:
- Member Evaluation: Conduct thorough evaluations using care management tools and data analysis.
- Enhancing Quality of Care: Consult with case managers to ensure medical appropriateness and quality of care using a holistic approach.
- Negotiation Skills: Leverage negotiation skills to secure necessary options and services to meet members' benefits.
- Motivational Interviewing: Utilize motivational interviewing techniques to maximize member engagement and promote healthier lifestyles.
- Coaching and Support: Provide coaching and information to empower members in making independent medical decisions.
- Healthcare Participation: Assist members in actively participating with their healthcare providers in decision-making.
- Monitoring and Documentation: Employ case management and quality management processes for effective monitoring and documentation of care.
- Flexibility and Team Collaboration: Demonstrate flexibility, organizational skills, and a passion for supporting class members of the Colbert Consent Decree.