Bancroft NeuroHealth

  • Case Manager

    Job Locations US-NJ-Plainsboro
    Requisition ID
    2018-5141
    Category
    Direct Support Management
    Status
    Full Time
  • Overview

    The Case Manager oversees the timely production, implementation and monthly or quarterly reporting on the Individualized Service Plans/IRP for the assigned caseload. The Case Manager will ensure that the decisions that affect the overall progression of a case including accessing Bancroft services, family advocacy, conflict resolution, internal transfers, discharge planning, and funding are clearly documented, communicated and carried out according to any applicable regulations and agreements.

     

    The Case Manager, working with Bancroft funding specialist staff, will ensure that all individuals served have been preauthorized by their insurer or state funding agency, that authorization status has been appropriately documented, that concurrent reviews are completed in a timely manner and collaborate with program managers, clinicians and staff to direct communication regarding issues relating to billing, representative payee status, and denial status.

     

    ** = indicates the task is program specific Treatment Plan includes Individual Habilitation Plan, Individual Service Plan, and Individual Rehabilitation Plan. Documentation and case review requirements vary based on funder and program. Practices will be implemented according to requirements dictated by DDD, JCAHO and CARF.

    Responsibilities

    Essential Responsibilities:

     

    1. Manage aspects related to individual cases that pertain to access to Bancroft services, family advocacy, conflict resolution, and funding and ensure cases are approached in a thoughtful, holistic manner that reflects Bancroft’s core values.
    2. Manage the authorization process for services in the pediatric, BNR and residential programs.
      1. On-going communication with treatment team to ensure services rendered have been authorized.
      2. On-going communication with treatment team to secure documentation required for the re-authorization process.
      3. Submit required documentation to the funder as necessary to secure authorizations
      4. Track, monitor and review authorizations to ensure submissions for re-authorizations are submitted in a timely manner.
      5. Support any appeal processes as necessary.
    3. Maintain accurate records of the concurrent review process; inform the treatment team and Billing Department of the authorization status of each assigned client.
    4. Communicate with external stakeholders as needed to develop collaborative relationships and clarify expectations.
    5. Track the timely completion and distribution of monthly, quarterly and annual treatment plan review with the funder, treatment team, and family as required by the funder and program regulations.
    6. Track internal team meetings and Interdisciplinary Team meetings and ensure that the documented meeting minutes are distributed.
      1. Monitor meeting minutes for clearly documented purpose and desired outcome.
      2. Ensure that action steps are assigned.
      3. Monitor the follow through on completion of tasks and achievement of goals.
    7. Ensures that any relevant data on achievement of goals is tracked in the clinical dashboard.
    8. Conduct utilization reviews of treatment plans.
    9. As needed assist program managers with client access of their full range of benefits through the utilization review process.
    10. Facilitate access to Bancroft services for internal clients.
      1. Facilitate eligibility and benefit checks.
      2. Upon request communicate benefits to the guardian and/or guarantor.
      3. Communication with Funding Specialists to ensure accurate recording of treatment plan and payer code rules.
    11. Participate in training regarding managed care initiatives and regulations.
    12. Monitor internal transfers:
      1. Support sending and receiving programs in planning logistics of the transfer.
      2. Communicate recommendations and logistics to guardian/family and funder.
      3. Manage associated rate changes; communicate to Billing Department.
      4. Ensure all records are updated accordingly.
    13. Secure funding for durable medical equipment.
    14. Serve as a resource for program managers and directors to resolve random, unassigned issues that impede the individual’s access to service, health and overall progression.
    15. Monitor the discharge planning process, communicating the discharge plan to family and funders, informing relevant departments within Bancroft, and collaborating with external case manager to secure new, appropriate care outside of Bancroft.
    16. Ensure that all pertinent contact information for each individual is accurately entered into the electronic database (Salesforce).

               

    When providing case management for the Bancroft Neuro Rehabilitation service line:

    1. *Coordinate the development of Individual Rehabilitation Plan’s.
    2. *Coordinate and facilitate Individual Rehabilitation Plan team meetings; ensure that the completed treatment plan is provided to the funder within the required time frame.

    Qualifications

    Education & Experience:

    Bachelor’s degree required. Minimum of two (2) years’ experience of related experience
    in case management and family advocacy required.
    Special Skills:
    Proven ability to effectively communicate both verbally and in written form required. Effective and proven ability to
    prioritize, multi-task; management skills required, as well as flexibility and adaptability. Ability to assess situations,
    problem solve and delegate tasks. Effective interpersonal and organizational skills. Basic math skills required.
    Operative knowledge of MS Office Word and Excel spreadsheets preferred. Valid driver’s license required in
    incumbent’s legal name and current address with no provisional restrictions. Minimum 18 years of age required.

    EEO Statement

    Bancroft is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, veteran status or any other characteristic protected by law.

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