Case Manager: Care Coordination & Client Advocacy

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

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.