Healthcare Consultant I (Social Worker)
Location: MID MIAMI AREA (33172, 33174,33175 33144,33134,33184,33165,33183,33193,33182).
Schedule: Monday–Friday, 8:00 AM–5:00 PM
Work Type: Field-Based / Telephonic
Travel: Approximately 50-75% within the Miami Dade County.
Education: Bachelor's Degree Required
Language: Fluency in English and Spanish Required
Job Description
We are seeking a self-motivated, energetic, detail-oriented, and highly organized Bilingual Case Management Coordinator to join our Case Management team in Miami Dade County, Florida.
The ideal candidate will be responsible for coordinating care for Medicaid members, conducting telephonic and face-to-face assessments, developing individualized care plans, and connecting members with appropriate healthcare services and community resources.
This role involves approximately 75% field travel to visit members in their homes, assisted living facilities, and nursing homes throughout the Miami Dade county area. Mileage will be reimbursed for travel to and from member homes.
Candidates must reside in Miami Dade County, FL (MUST BE IN ONE OF THESE ZIP CODES.MID MIAMI AREA) (33172, 33174,33175 33144,33134,33184,33165,33183,33193,33182)
Key Responsibilities
Coordinate case management activities for Medicaid Long-Term Care and Comprehensive Program members.
Conduct comprehensive telephonic and face-to-face assessments to evaluate members' healthcare needs.
Develop, implement, and monitor individualized care plans to improve health outcomes.
Coordinate care with primary care providers, specialists, and multidisciplinary healthcare teams.
Assist with prior authorizations and arrange appropriate healthcare services.
Provide condition management education, medication reviews, and ongoing member support.
Connect members with community resources and support services.
Utilize motivational interviewing and coaching techniques to encourage member engagement and healthy lifestyle choices.
Empower members to actively participate in healthcare decisions and manage their ongoing medical needs.
Monitor care plan progress, document activities, and identify opportunities to improve quality of care.
Escalate quality-of-care concerns through established procedures.
Ensure compliance with company policies, regulatory requirements, and quality management standards.
Required Qualifications
Bachelor's degree required. Social Work or a related field preferred.
Minimum of 1 year of case management experience is required.
Fluency in both Spanish and English is mandatory.
Candidates must reside in Miami Dade County, FL (MUST BE IN ONE OF THESE ZIP CODES.MID MIAMI AREA) (33172, 33174,33175 33144,33134,33184,33165,33183,33193,33182)
Strong communication, organizational, and problem-solving skills.
Proficiency in Microsoft Office, including Excel.
Ability to manage multiple priorities and adapt to a fast-paced environment.
Strong interpersonal skills and the ability to work independently.
Must be comfortable with approximately 75% local field travel.
High School Diploma or GED must be verifiable.
Preferred Qualifications
Long-Term Care experience.
Case Management Certification.
Experience working with Medicaid members or medically complex populations.
Experience coordinating care in home health, assisted living, or nursing home settings.
Work Schedule & Training
Monday–Friday, 8:00 AM–5:00 PM.
Standard business hours.
Initial training will be conducted remotely through Microsoft Teams.
Approximately 50-75% travel within the Tampa region for face-to-face member visits.
Mileage reimbursement provided for travel to and from member homes.
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