Healthcare Consultant I - Central/Southeast OHIO

Apidel Technologies is focused on delivering managed care services in Ohio Medicaid. They are seeking a Healthcare Consultant I who will provide comprehensive healthcare management services, facilitate appropriate healthcare treatment, and manage healthcare costs while ensuring effective care coordination for members in Central/Southeast Ohio.

Responsibilities:

• 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

Requirements:

• Bachelors degree or non-licensed master level clinician required
• 2+ years of experience in behavioral health, social services, or human services
• 2+ years of experience with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint)
• 2+ years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or a public sector human services or behavioral health care field, providing community-based services to children and youth, and their family/caregivers
• 2+ years experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development
• 2+ year of experience with Ohio delivery systems, including local community networks and resources
• Willing and able to travel within the assigned region up to 50% of the time; Some travel to the New Albany office may be required for trainings/meetings
• Reliable transportation required
• Mileage is reimbursed per our company expense reimbursement policy
• Willing and able to work beyond core business hours of Monday-Friday, 8am-5pm, as needed
• Bachelors degree or non-licensed master level clinician required, with either degree being in behavioral health, human services, health services, or public health preferred
• Case management and discharge planning experience
• Managed Care experience
• Medicaid experience