Case Manager - Application

SSM Health; St. Louis (MO); On-site; USD 45,000 - 60,000; Full time

Job summary

SSM Health Ambulatory Care Center CSM is seeking a full-time Behavioral Health navigator to screen patients without insurance for Medicaid, Medicaid CAU, state health exchange plans, and Social Security Disability, and to complete related applications.

The role assesses social needs, refers to appropriate resources, and supports patients through the application and appeals processes, with a Monday–Friday day shift in Missouri.

Qualifications

• Bachelor's degree required.
• Three years experience required.

Responsibilities

• Completes applications and follow up documentation, including obtaining verification, submitting applications in person or electronically, attending appointments with or for the patient and constructing medical history, in an effort to establish disability as required by Medicaid and Social Security Disability.
• Manages the appeal process by following up on appeals in a timely manner.
• Sets appropriate goals with every patient and contacts patients in a timely manner to update goals.
• Connects patients with appropriate public and private assistance programs based on needs identified during the initial assessment, re-assessment, and goal planning with the patient.
• Communicates patient and family needs to outside agencies.
• Communicates with billing and local providers that the patient is approved so proper billing can take place.
• Follows up regularly on applications with patients and the Medicaid, state health insurance exchange, and Social Security Disability offices to ensure the application process is completed.
• Works in a constant state of alertness and safe manner.
• Performs other duties as assigned.

Job description

It's more than a career, it's a calling.

MO-SSM Health Ambulatory Care Center CSM

Worker Type:

Regular

Job Highlights:

Join a team where your work matters – every moment, every patient, every community. At SSM Health, you’ll be empowered to grow, supported to thrive, and inspired to make a lasting impact.

Department:

Behavioral Health

Schedule:

Full time, day shift, Monday through Friday, 8am to 5pm

Job Summary:

Screens and interviews patients without insurance for Medicaid, Medicaid CAU, private insurance through the state health exchange, and Social Security Disability and completes applications for eligible patients. Assesses the patient's social needs and refers to appropriate resources.

Primary Responsibilities

• Completes applications and follow up documentation, including obtaining verification, submitting applications in person or electronically, attending appointments with or for the patient and constructing medical history, in an effort to establish disability as required by Medicaid and Social Security Disability.
• Manages the appeal process by following up on appeals in a timely manner.
• Sets appropriate goals with every patient and contacts patients in a timely manner to update goals.
• Connects patients with appropriate public and private assistance programs based on needs identified during the initial assessment, re-assessment, and goal planning with the patient.
• Communicates patient and family needs to outside agencies.
• Communicates with billing and local providers that the patient is approved so proper billing can take place.
• Follows up regularly on applications with patients and the Medicaid, state health insurance exchange, and Social Security Disability offices to ensure the application process is completed.
• Works in a constant state of alertness and safe manner.
• Performs other duties as assigned.

EDUCATION

• Bachelor's degree

Experience

• Three years experience

Physical Requirements

• Frequent reaching, sitting, standing and walking.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more).
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, climbing, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Occasional use of vision to identify and distinguish colors.
• Occasional driving.
• Rare repetitive foot/leg and hand/arm movements and squatting.

Required Professional License And/Or Certifications

• None

Work Shift:

Day Shift (United States of America)

Scheduled Weekly Hours:

40

SSM Health is an Equal Opportunity Employer. SSM Health provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law. Click here to learn more.