Case Manager

4 weeks ago

Point Pleasant WV, United States BrightSpring Health Services Full time

Job Summary

We are seeking a skilled Case Manager to join our team at BrightSpring Health Services. As a Case Manager, you will be responsible for ensuring the highest level of care for our clients by coordinating their services and resources.

Key Responsibilities

  • Receives and responds to incoming calls from referral sources and potential clients, exchanging information to identify their needs and consulting with the Director of Clinical Management to determine our ability to meet them.
  • Completes all viable referrals by setting up and carrying out pre-screening assessments, completing pre-screening reports, and preparing case proposals and other related pre-admission paperwork.
  • Oversees, directs, and supervises field staff assigned to assist with the pre-screening process.
  • Accesses national, state, and company account information, including account names and terms of contracts or other past payer agreements.
  • Consults with third-party representatives regarding client benefit coverage, client financial responsibility, company service authorization, and specific reimbursement procedures.
  • Contacts referral sources to advise them of case acceptance and provides information on the clinical team responsible for the client's case.
  • Develops and maintains a working knowledge of all services and resources provided by the company and services available within the community.
  • Maintains relationships with standard referral sources and payer case managers, contacts identified referral sources, and seeks referrals as appropriate.
  • Monitors and tracks referral sources' satisfaction levels, tracks and reports on conversion ratios, and provides summary reports to management at requested intervals.
  • Implements and maintains operational processes to ensure compliance with company policies, requirements, and regulatory mandates.
  • Adheres to and participates in the company's mandatory HIPAA privacy program and Business Ethics and Compliance programs.
  • Participates in quarterly growth planning meetings and activities, including discussions around staffing and recruitment needs.
  • Participates in special projects and performs other duties as assigned.

Requirements

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

About Our Line of Business

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.

We connect 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, we provide personalized guidance and training on basic life skills, including money management, life skills, and education.

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