Foster Care Case Manager
About The Position
The Foster Care Case Manager handles referrals and pre-admission coordination, determining client needs and consulting with the Director of Clinical Management on whether the Company can meet them. The role completes pre-screening assessments and reports, prepares case proposals and related paperwork, and coordinates payment authorization and treatment-team availability. It also oversees field staff involved in pre-screening. The position works with third-party representatives and referral sources on service authorization, coverage, reimbursement, and case acceptance. It maintains knowledge of Company and community services, supports referral relationships, monitors referral satisfaction and conversion measures, and helps ensure operational compliance with Company policies and regulatory requirements. The role also participates in growth-planning activities and special projects.
Requirements
- Bachelor's degree in a human services field or nursing field.
- Valid driver's license.
- Two years of experience in case management or a related discipline.
- Ability to communicate verbally and in writing.
Responsibilities
- Respond to referral-source and potential-client calls, identify client needs, and consult with the Director of Clinical Management about the Company's ability to meet them.
- Complete viable referrals by conducting pre-screening assessments, preparing reports and case proposals, and completing related pre-admission paperwork.
- Obtain payment authorization and coordinate the availability of an appropriate treatment team.
- Oversee, direct, and supervise field staff assigned to assist with the pre-screening process.
- Access national, state, and Company account information, including contract terms and prior payer agreements, as appropriate.
- Consult with third-party representatives about benefit coverage, client financial responsibility, service authorization, and reimbursement procedures.
- Present Company services, explain potential reimbursement options, and negotiate reimbursement levels with third-party payers.
- Notify referral sources of case acceptance and provide information about the clinical team responsible for the client.
- Maintain knowledge of Company services and community resources, and help identify alternatives when Company services are not appropriate or available.
- Maintain relationships with referral sources and payer case managers, seek referrals, record call outcomes, and keep the SAR informed.
- Monitor referral-source satisfaction, track and report conversion ratios, and provide summary reports to management when requested.
- Work with up-line management to implement and maintain operational processes that comply with Company policies, requirements, and regulatory mandates.
- Participate in the Company's HIPAA privacy, Business Ethics, and Compliance programs.
- Participate in quarterly growth-planning meetings and activities, including staffing and recruitment discussions.
- Participate in special projects and perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
