Job Description:

• Enhancement of Medical Appropriateness and Quality of Care:- Using holistic approach consults with utilization management clinicians, hospital discharge planning staff, supervisors, and/or other health programs to overcome barriers to meeting goals and objectives;

• -Coordinates care with providers as a part of comprehensive and proactive discharge planning.

• -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 member actively and knowledgably participate with their provider in healthcare decision-making

Responsibilities:

• utilizes critical thinking and judgment to collaborate and inform the case management/concurrent review process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management/concurrent review tools and resources. Will assist with discharge plans, and outreach to members, assist with HH/DME issues.

Experience:

• Case management and discharge planning experience

• call center experience

• Preferred strong customer service skills

• Strong problem-solving and analytical skills

• Possess strong computer navigation skills

• Comfortable with regular feedback and development

• Works well in a team environment

• Must have basic medical terminology experience

Skills:

• Preferred strong customer service skills

• Strong problem-solving and analytical skills

• Possess strong computer navigation skills

• Comfortable with regular feedback and development

• Works well in a team environment

• Must have basic medical terminology experience

Education:

• High school diploma or GED required,

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,

national origin, disability, or status as a protected veteran.