Healthcare Consultant III - Care Management Associate
Job in
Central City, Muhlenberg County, Kentucky, 42330, USA
Listed on 2026-10-18
Listing for:
SGS Consulting
Full Time
position Listed on 2026-10-18
Job specializations:
-
Healthcare
Mental Health, Community Health, Health Education & Promotion, Patient/Health Advocate
Job Description & How to Apply Below
Job Responsibilities
- Using care management assessments and information/data review, recommends an approach to resolving care needs maintaining optimal health and well-being 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 implements early and proactive support interventions.
- Coordinates and implements Wellness care plan activities and monitors member care needs.
- 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 members to make ongoing independent medical and/or healthy lifestyle choices.
- Help members actively and knowledgably participate with their provider in healthcare decision-making.
- Monitoring, Evaluation and Documentation of Care:
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
- Minimum 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention services or evidence-based practices applicable to the Kentucky SKY populations.
- Minimum 2 years of experience required in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
- Minimum 1 year of experience in MS Office Suite applications, including Word and Excel.
- Willing and able to travel 10-15% of their time to meet members face to face in their assigned region.
- Minimum of a Bachelor's degree or a non-licensed master level clinician is required with either degree being in behavioral health or human services field.
Position Requirements
10+ Years
work experience
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