Foster Care Case Manager

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.
• Affords assistance 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.
• Maintains relationships with standard referral sources and payer case managers.
• 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.