Case Manager
4 weeks ago
At BrightSpring Health Services, we are seeking a skilled Case Manager to join our team. As a Case Manager, you will play a critical role in ensuring the best possible outcomes for our clients.
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, as appropriate.
- 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.
- Bachelor's degree in a human services field or nursing field.
- Valid driver's license.
- Two years of experience in case management or a related discipline.
- Ability to communicate both verbally and in writing.
We offer a competitive salary range of USD $17.50 per hour and a dynamic work environment that values employee growth and development.
At BrightSpring Health Services, we are committed to creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information from you via text or email.
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