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, consulting with the 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, completing pre-screening reports, and preparing case proposals and other related pre-admission paperwork (e.g., obtaining authorization for payment, coordinating availability of an appropriate treatment team).
Oversees, directs, and supervises field staff assisting with the pre-screening process.
Accesses national, state, and company account information, including account names and terms of contracts or past payer agreements.
Consults with third-party representatives regarding client benefit coverage, financial responsibilities, service authorization, and reimbursement procedures. Presents services, interprets reimbursement options, and negotiates reimbursement levels.
Contacts referral sources to advise case acceptance and provides information on the clinical team responsible for the client’s case.
Develops and maintains knowledge of all services/resources provided by the company and within the community; assists in identifying alternative community service sources when company solutions are not appropriate or available.
Maintains relationships with referral sources and payer case managers; seeks referrals and records outcomes of calls.
Monitors referral source satisfaction levels, tracks conversion ratios, and provides reports to management.
Implements operational processes to ensure compliance with company policies, requirements, and regulations.
Participates in mandatory HIPAA privacy, Business Ethics, and Compliance programs.
Participates in quarterly growth planning activities, including staffing and recruitment discussions.
Participates in special projects and performs other duties as assigned.
Qualifications Bachelor's degree in human services or nursing.
Valid driver's license.
At least two years of experience in case management or a related discipline.
Ability to communicate effectively both verbally and in writing.
About our Line of Business ResCare Community Living, an affiliate of BrightSpring Health Services, has over five decades of experience in the disability services field, supporting individuals with intellectual, developmental, or cognitive disabilities. We offer a range of services, including community living, adult host homes, behavioral/mental health support, in-home pharmacy, telecare, remote support, supported employment, training programs, and day programs. For more information, visit www.rescarecommunityliving.com . Follow us on Facebook and LinkedIn.
Salary Range: USD $20.00 - $24.00 per hour