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ADvantage Case Manager
4 months ago
Accentra Is an Oklahoma Owned Company
We pride ourselves on achieving the best possible outcomes for our patients and providing quality of care – whether that involves home health for managing chronic conditions, injury or illness; or hospice to provide end-of-life care and comfort. We strive to help our patients remain safe and independent at home while achieving the best quality of life possible. Thousands of families, physicians, and facilities across Oklahoma choose Accentra because of the quality care our team members provide. We value our team members and celebrate their accomplishments - we know that our team is the foundation on which our company is built. We invite you to learn more about Accentra and what has made us one of the most respected names in home care.
Our Employees enjoy the following benefits:
- Company Car or Paid Mileage
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Flex Spending Plans
- Paid Holidays
- Paid Time Off
- Longevity Pay
- Performance Bonuses
- 401(k)
- Referral Program Bonuses
- Competitive Salary and Benefits
The Advantage Case Manager serves clients within the Advantage Waiver Program with case management services.
Qualifications
- Excellent verbal and written communication skills
- Valid Driver’s License
- Minimum of two years of paid experience as a case manager or related discipline
- A baccalaureate degree in a human services field or nursing
- Knowledge of ADvantage Medicaid Waiver systems is preferred
Responsibilities
- Receives/responds to incoming calls from referral sources/potential clients, evaluates information to identify the client’s needs and consults with the ADvantage Case Management Supervisor to determine how Accentra can best meet the client’s needs.
- Completes all referral documentation including pre-screening assessments, pre-screening reports, and preparation of case proposals as well as other related pre-admission paperwork (i.e., authorization for payment, and coordination of other disciplines).
- Oversees, directs and supervises field staff assigned in assisting with pre-screening process.
- Communicatees effectively with AAU, other Accentra staff members and those involved in Client care.
- Consults with third party representatives regarding client benefit coverage, client financial responsibility, company service authorization and specific reimbursement procedures. Presents 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 care.
- Develops and maintains a working knowledge of all services and resources provided by Accentra as well as those available within the community. Assists in identifying alternative community service resources when company solutions are not appropriate or available.
- Monitors and tracks client and referral source satisfaction levels, tracks and reports on conversion ratios and provides summary reports to management at requested intervals.
- Follows and assists with the development of operational processes to ensure compliance with Accentra, State and Federal policies, requirements and regulatory mandates.
- Adheres to and participates in Company’s mandatory HIPAA privacy policy, Business Ethics and Compliance programs.
- Participates in special projects and performs other duties as assigned.
- Establishes methods for coordination of care by all disciplines serving the Client.
- Promotes coordination of care among all professional and paraprofessional disciplines involved in Client care.
- Participates in Accentra in-service programs and ensures requirements are met.
- Consults with the ADvantage Case Management Supervisor regarding ways to solve problems and maintain or improve high standards of care.
- Participates in community activities to further the work of Accentra.
- Gives leadership in promoting and maintaining standards for giving high quality care by all members of the Client care team.
- Assumes other duties as assigned by ADvantage Case Management Supervisor, the Executive Team or other Administrator.
Functional Abilities
- Able to communicate verbally and in writing to the extent required by the position.
- Able to physically perform the duties required by the position.
- Able to travel to a prospective Client’s place of residence.
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds at a time.
