Foster Care Case Manager

BrightSpring Health Services; Kentucky; Sur place; USD 60 000 - 75 000; Plein temps

Résumé du poste

BrightSpring Health Services is seeking an operational team member to coordinate referrals, perform pre-screening activities, and support the clinical management process. You will oversee field staff and coordinate with payer providers to ensure appropriate service delivery and timely authorizations.

The role requires a Bachelor's degree in a human services or nursing field, a valid driver's license, and at least two years of case management experience, with strong written and verbal

Qualifications

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

Responsabilités

• Receives/responds to incoming calls from referral sources and consults to determine client needs.
• Completes referrals by setting up pre-screening, reports, and case proposals.
• Oversees field staff assisting with pre-screening processes.
• Accesses account information and past payer agreements as appropriate.
• Consults with third party representatives on benefit coverage and reimbursement options.
• Contacts referral sources to advise case acceptance and share clinical team details.
• Maintains knowledge of services and community resources available.
• Maintains relationships with referral sources and payer case managers.
• Tracks referral source satisfaction and reports to management.
• Implements operational processes to ensure compliance with policies.
• Participates in HIPAA/privacy and ethics/compliance programs.
• Participates in growth planning and special projects.

Connaissances

Verbal communication

Written communication

Communication

Formation

Bachelor's degree in human services or nursing

Description du poste

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.

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.