Recovery Support Specialist (Case Manager)

About the role

Spero Health is seeking a Recovery Support Specialist (Case Manager) to join our team in Somerset, KY. This role supports the mission of “Saving Lives, Instilling Hope and Restoring Relationships” within an integrated team providing counseling, case management, and medically assisted treatment. Spero Health believes better outcomes are achieved by treating the whole person through integrated care.

Responsibilities

• Assess patient needs and barriers
• Develop and implement the treatment plan in collaboration with the patient
• Maintain current assessments, treatment plans, and supporting clinical documentation required for prior authorization submissions, continued stay reviews, and reauthorizations
• Prepare, submit, and monitor prior authorization requests in accordance with payer requirements and organizational policies
• Respond promptly to requests for additional clinical information and collaborate with the Authorization Team, providers, and clinic leadership to ensure payer approval
• Maintain knowledge of payer-specific authorization requirements, medical necessity criteria, and organizational workflows to ensure timely access to care and minimize authorization denials
• Advocate on behalf of the patient for needed services and benefits
• Connect patients with appropriate resources and assist them with obtaining their needs such as transportation, medical assistance, etc.
• Provide education, modeling, and support in the areas of daily living, budgeting, money management, and medication management
• Engage patient in recovery-oriented, patient-centered care in accordance with professional standards of practice
• Complete required documentation in an appropriate and timely manner
• Ensure compliance with HIPAA and CFR 42 Part 2 regulations
• Collaborate with all members of the multidisciplinary team to enhance patient experience and continuity of care
• Community outreach as applicable

Requirements

• Bachelor of Arts or Science degree in a behavioral science or a Master's Degree in Human Services
• Minimum of 1 year of full-time employment/internship working in a human-services setting OR Master's Degree in behavioral science

Benefits

• Medical, Dental, and Health Savings Account
• Vision, Life, and Disability insurance (100% Company Paid)
• Generous PTO and paid holidays
• 401(k) retirement program with company match
• Wellness Programs (Fitness Reimbursement & Smoking Cessation)
• Employee Assistance Program (EAP)
• Discounts via Tickets at Work
• Loan Forgiveness Programs: Access to help pay off federal student loans through the STAR (Substance Use Disorder Treatment and Recovery) program

Career Development and Growth

Opportunities for growth—we encourage teammates to consider new growth opportunities within the organization. For more information, visit Spero Health’s website.