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Company: BrightSpring Health Services
Location: Racine
Posted on: June 17, 2022

Job Description:

Equus Workforce SolutionsOur 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!

  • 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. Assists 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.
  • 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.
    • 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.Equus Workforce Solutions,formerly ResCare Workforce Services, is the nations leading provider of workforce development services in North America. With a dedicated and passionate team, Equus puts the industrys best practices to work nationwide by focusing on the development, design, and delivery of demand-driven workforce solutions. Assisting over a million job seekers and thousands of employers annually, Equus Workforce Solutions is the most comprehensive workforce development company in the United States. For more information visit .GENERAL SUMMARYThe Talent Development Specialist (TDS) - Lead is responsible for understanding Wisconsin Works (W-2) policies and procedures, updating Standard Operating Procedures (SOP), and training TDS staff. The TDS - Trainer will report to the Deputy Director and may carry a caseload, when needed, to assist with operations. ESSENTIAL JOB RESPONSIBILITIES - - - - - - - - - - - Understand Wisconsin Works (W-2) operational policies and procedures - - - - - - - - - - - Create, update, and maintain Standard Operating Procedures (SOP) - - - - - - - - - - - Train Talent Development Specialists (TDS) on operational policies, procedures, and SOPs - - - - - - - - - - - Assist Lead TDS with auditing of team members and offer recommendations on additional training - - - - - - - - - - - Able to work independently/self-starter while remaining in communication with Deputy Director - - - - - - - - - - - - May need to meet with job seekers/participants and carry a case load - - - - - - - - - - - - Identify barriers to employment and develop strategies to manage these issues - - - - - - - - - - - -QUALIFICATIONS/EDUCATIONAssociate's Degree in Human Services, Social Work, or a related field and minimum two to three year's work experience in Human Services preferability as a Case Manager, or a satisfactory equivalent of education and experience -Proven ability to manage a case load -Able to work with and relate to job seekers and be culturally sensitive and knowledge about community resources -Strong communication and organizational skills and excellent internal and external customer service skills -Must be computer literate and have MS Word and Excel skills at minimum, and the ability to learn specialized databases and software systems -Bilingual a plusTRAVEL REQUIREMENTSMinimal WORK ENVIRONMENT AND PHYSICAL DEMANDSExtensive standing, sitting, computer, phone, deskwork and extensive data entry requires; work primarily in a defined office environment with specified hours, although flexible hours may be required; interacts one on one and in groups with individuals from a diverse range of backgrounds; availability for occasional out of office meetings. - - -

Keywords: BrightSpring Health Services, Racine , LEAD CASE MANAGER, Executive , Racine, Wisconsin

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