Case Manager
Oklahoma City, OK - USA
Job Summary
All Ways Caring HomeCare
Our operational team members focus on efficiently meeting the needs of our clients across various lines of business. If your passion is to ensure quality care to help our clients live their best life we encourage you to apply today!
- 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 Companys 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 companys 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 clients 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 Companys 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.
- Bachelors degree in a human services field or nursing field.
- Valid drivers license.
- Must have two years of experience with case management or related discipline
- Must be able to communicate both verbally and in writing.
All Ways Caring HomeCaredelivers quality compassionate and individualized care and support that helps people in need of assistance stay at home all while maximizing their dignity privacy and independence. Whether recovering from illness injury or surgery living with a chronic disability or dealing with the natural process of aging services are tailored to meet the individual needs of people of all ages physical conditions and cognitive abilities. All Ways Caring HomeCare services include personal care and homemaking programs professional nursing older adult care management Alzheimers/dementia care respite care and other programs. For more information please visit . Follow us on Facebook and LinkedIn.
Required Experience:
Manager
About Company
BrightSpring Health Services is a leading provider of comprehensive home and community-based health services to complex populations.