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BrightSpring Health Services

Home-based health services and pharmacy solutions

Youth Services Case Manager

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeNo salary listedIn-person

About the Job

Requirements

  • A bachelor's degree in a human services field or nursing field.
  • A valid driver's license.
  • At least two years of experience in case management or a related discipline.
  • Ability to communicate verbally and in writing.

Responsibilities

  • Respond to incoming calls from referral sources and potential clients, 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 pre-screening reports and case proposals, and completing related pre-admission paperwork, including obtaining payment authorization and coordinating an appropriate treatment team's availability.
  • Oversee, direct, and supervise field staff assigned to assist with the pre-screening process.
  • Access national, state, and company account information, including account names and contract terms or other past payer agreements, as appropriate.
  • Consult with third-party representatives about client benefit coverage, financial responsibility, service authorization, and reimbursement procedures; present company services, interpret reimbursement options, and negotiate reimbursement levels with third-party payers.
  • Inform referral sources of case acceptance and identify the clinical team responsible for each client's case.
  • Maintain knowledge of company services and community resources, and help identify alternative community service sources when company services are not appropriate or available.
  • Maintain relationships with referral sources and payer case managers; contact identified referral sources to seek referrals and record call outcomes for the SAR.
  • Monitor referral-source satisfaction, track and report conversion ratios, and provide summary reports to management when requested.
  • Implement and maintain operational processes with upper management to ensure compliance with company policies, requirements, and regulatory mandates.
  • Follow the company's HIPAA privacy practices and Business Ethics and Compliance programs.
  • Participate in quarterly growth-planning activities, including discussions about staffing and recruitment needs.
  • Participate in special projects and perform other assigned duties.

About the Company

BrightSpring Health Services

Home-based health services and pharmacy solutions

BrightSpring Health Services delivers home and community-based health services for people with complex or chronic needs, organized into two segments: Pharmacy and Provider. The Pharmacy segment provides specialty, infusion, and community pharmacy services to patients with complex conditions. The Provider segment offers behavioral health, home health, hospice care, and services for individuals with intellectual and developmental disabilities. The company runs an integrated care model through a network of pharmacies and providers to support a continuum of care that includes clinical services, care coordination, and in-home support. Revenue comes from Medicare, Medicaid, and private insurance, reflecting reimbursement across public and private payers. The goal is to coordinate pharmacy and in-home health services to improve access, continuity, and outcomes for patients and to serve managed care organizations with a complete care solution.

Company size
10,001+
Company stage
IPO
Headquarters
Lyndon, KY
Founded
1974

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