Foster Care Case Manager

BrightSpring Health Services; Prestonsburg (KY); On-site; USD 26,000 - 29,000; Full time

Job summary

BrightSpring Health Services, via its StepStone Family & Youth Services affiliate, seeks a Referral Coordination/Case Management professional in Kentucky. The role handles referral intake, pre-screening, and co-management with clinical leadership, guiding field staff and payer negotiations while ensuring HIPAA and program compliance.

A bachelor’s degree in human services or nursing and a valid driver's license are required.

Qualifications

• Bachelor's degree in human services or nursing.
• Valid driver's license.
• Two years of experience with case management.
• Ability to communicate verbally and in writing.

Responsibilities

• Receives and responds to incoming calls from referral sources or potential clients to assess needs and consult with the Director of Clinical Management to determine capabilities.
• Completes referrals by arranging pre-screening assessments, reports, and pre-admission paperwork, including authorization for payment and coordinating treatment team availability.
• Oversees and guides field staff assisting with the pre-screening process.
• Accesses account information and past payer agreements as appropriate.
• Consults with third-party representatives on benefit coverage, financial responsibility, and reimbursement procedures; negotiates levels with payers.
• Contacts referral sources to inform case status and provide information on the clinical team.
• Maintains knowledge of services and community resources and identifies alternatives when needed.
• Maintains relationships with referral sources and payer case managers; records outcomes and reports results.
• Monitors referral source satisfaction, tracks conversions, and provides management with summaries.
• Implements operational processes to ensure compliance with company policies and regulatory requirements.
• Adheres to HIPAA privacy and business ethics/compliance programs.
• Participates in quarterly growth planning and staffing discussions.
• Performs special projects and other duties as assigned.

Skills

Verbal and written communication

Education

Bachelor's degree in human services or nursing

Job description

Our Company

StepStone Family & Youth Services

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!

Responsibilities

• 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.

About our Line of Business

StepStone Family and Youth Services, an affiliate of BrightSpring Health Services, provides the full spectrum of support to children in need of alternative, safer, and more positive living environments with residential and family services. StepStone connects children and youth who need homes with foster families, as well as foster care training, respite care and support services. For young adults transitioning from foster care to independent living, StepStone provides personalized guidance and training on basic life skills, including money management and education. For more information, please visit www.stepstoneyouth.com. Follow us on Facebook and LinkedIn.

Salary Range

USD $19.00 - $19.23 / Hour