CASE MANAGER - HENN COUNTY
Company: ResCare Community Living
Location: Woodbury
Posted on: October 27, 2024
Job Description:
Our Company
ResCare Community Living
Overview
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!
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
ResCare Community Living has four decades of experience in the
disability services field, providing support to individuals who
need assistance with daily living due to an intellectual,
developmental or cognitive disability. Our community living
services are provided in 27 states with several thousand programs
and a comprehensive range of high-quality services, including:
Community Living, Adult Host Homes for adults regardless of
disability, Behavioral/Mental Health Support, In-home Pharmacy
Solutions, Telecare and Remote Support, Supported Employment and
Training Programs, and Day programs. For more information, please
visit www.rescarecommunityliving.com. Follow us on Facebook and
LinkedIn.
Additional Job Information
We are looking for someone with the following qualifications
according to the MN Merit System requirements:
- A graduate from an accredited four-year college with a major in
social work, psychology, sociology, or a closely related field,
or
- A graduate from an accredited four-year college with a major in
any field and one-year experience as a social worker in a public or
private social service agency, and Preferred requirements:
- One-year experience working as a case manager or service
coordination
- Excellent written and oral communication skills
This person will be responsible for 45-50 cases of CADI and BI
waiver clients along with other adminsitrative duties related to
this position, including developing CSSPs, providing service
coordinatation, drafting USAs for service authorizations, and
billing.
Salary Range
USD $24.00 / Hour
Keywords: ResCare Community Living, Edina , CASE MANAGER - HENN COUNTY, Executive , Woodbury, Minnesota
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