Care Management Support Specialist

Careforth•Dayton, OH

5d•Remote

About The Position

A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. Through a combination of in-person home visits, remote coaching and our proprietary digital collaboration app, we provide caregivers with support, guidance, confidence, and connection to resources they need. The Caregivers and families we support stay with Careforth for many years, building lasting relationships along the way. Join us today and live our values: lead with heart, cultivate trust, go beyond. Reporting to the Manager, Care Management, the Care Manager Support Specialist (CMSS) is responsible for a wide array of administrative and operational activities to support care management team(s). The CMSS will assist the Manager and care teams with care coordination, community resource referrals, internal audits, and ongoing compliance with credentialing and state requirements. In addition, the CMSS will help to ensure timely communication with internal/external stakeholders in support of the delivery of care management service delivery.

Requirements

2-4 years of experience in an operations or administrative role, preferably in a case management or healthcare setting
Proficiency in Microsoft Office Suite (Excel, Word, Outlook)
Strong communication skills, excels in professional interactions by phone and writing
Strong attention to detail and experience with data integrity in a regulated environment
Strong business acumen with desire to understand end to end business operations

Responsibilities

Assist the Care Management team with internal and external communication, including making referrals for community resources as requested by the care team.
Assist the team with caregiver credentialing and caregiver expirables that are required per regulation.
Assist with tracking authorizations for continued service delivery.
Review denied and ineligible reports from the medical billing team; Work with appropriate stakeholders to assist with claim resolution and update systems of record where applicable
Monitor and manage emails and phone calls related to the Structured Family Caregiving and Shared Living programs; Follow-up with care team members and provide documentation to relevant parties as needed
Run routine reports within Salesforce (e.g. compliance tasks, census, open incidents, IOS, etc.) and provide updates to care teams and managers as needed.
Utilize dashboards and reports within the case management system to drive efficient outcomes and understand trends (e.g. obtaining timely authorizations, managing referrals, branch timeliness)
Assist with compliance audits, both internal and external
Assist with caregiver and team technology-related issues as they arise
Occasional travel to a caregiver’s home may be required.
Perform other projects and duties as assigned