Case Manager

All Ways Caring HomeCare; Oklahoma City (OK); On-site; USD 54,552,960 - 77,696,640; Full time

Job summary

All Ways Caring HomeCare is seeking a qualified candidate for a role focusing on case management in Oklahoma City. The responsibilities include managing referrals, overseeing pre-screening processes, and maintaining relationships with referral sources and payers.

The ideal candidate will have a Bachelor's degree in a human services field or nursing, along with two years of relevant experience. A valid driver's license is also necessary for this position.

Qualifications

• Two years of experience with case management or a related discipline.
• Valid driver's license is required.

Responsibilities

• Receive and respond to calls from referral sources.
• Complete pre-screening assessments and related paperwork.
• Supervise field staff assisting with the pre-screening process.
• Consult with third-party representatives regarding client coverage.
• Develop knowledge of services offered by the company.

Skills

Communication skills

Case management knowledge

Education

Bachelor's degree in a human services field or nursing field

Job description

Our Company

All Ways Caring HomeCare

Overview

Our operational team members focus on efficiently meeting the needs of our clients across various lines of business. If your passion is to ensure quality care to help our clients live their best life we encourage you to apply today!

External Job Description

• Receives/responds to incoming calls from referral sources/potential clients and exchanges information to identify the clients' needs and consults with Director of Clinical Management to determine the Company's ability to meet them.
• Completes all viable referrals by setting up and carrying out pre-screening assessments, completion of pre-screening reports, and preparation of case proposals and other related pre-admission paperwork (i.e., obtains authorization for payment, coordinates availability of an appropriate treatment team).
• Oversees, directs and supervises field staff assigned in assisting with pre-screening process.
• Accesses national/state/company account information, including the account names and terms of contracts or other past payer agreements, as appropriate.
• Consults with third party representatives regarding client benefit coverage, client financial responsibility, company service authorization and specific reimbursement procedures. Presents company’s services, interprets potential reimbursement options and negotiates reimbursement levels with third party payer.
• Contacts referral sources to advise them of case acceptance and provides information on the clinical team responsible for client's case.
• Develops/maintains a working knowledge of all services/resources provided by the Company and services available within the community. Assists in identifying alternative community service sources when company solutions are not appropriate or available.
• Maintains relationships with standard referral sources and payer case managers. Contacts identified referral sources and seeks referrals as appropriate. Records outcome of calls and keeps the SAR informed.
• Monitors/tracks referral sources' satisfaction levels, tracks/reports on conversion ratios and provides summary reports to management at requested intervals.
• Implements/maintains, with the up line management, operational processes to ensure compliance with Company policies, requirements and regulatory mandates.
• Adheres to and participates in Company’s mandatory HIPAA privacy program/practices and Business Ethics and Compliance programs.
• Participates in quarterly growth planning meetings/activities including discussions around staffing and recruitment needs.
• Participates in special projects and performs other duties as assigned.

Qualifications

• Bachelor's degree in a human services field or nursing field.
• Valid driver's license.
• Must have two years of experience with case management or related discipline
• Must be able to communicate both verbally and in writing.

Salary Range

USD $24.00 / Hour