Job Description
If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.
Medical Insurance Program Case Manager
Full Time Tallahassee, FL, US
9 days ago Requisition ID: 1047
Salary Range: $36,400.00 To $36,400.00 Annually
POSITION TITLE: MED and INSURANCE PROGRAM CASE MANAGER
DEPARTMENT: Client Services
TYPE OF POSITION: Full-time (Monday-Friday 8:00 a.m. to 5:00 p.m.)
GENERAL FUNCTION: The Medical and Insurance Program Case Manager provides social work and client advocacy services to clients of Big Bend Cares and reports to the Director of Client Services.
JOB REQUIREMENTS:
Assists HIV positive clients with improving their health by providing client-centered activities, including:
Conducting annual comprehensive eligibility determinations.
Assessing service needs and developing comprehensive, individualized care plans.
Providing timely and coordinated linkage and access to core medical and support services.
Enrolling Insurance Program participants in compliance with program requirements.
Coordinating with Chief Pharmacy Officer on Insurance Program premiums and 340B rebates.
Educating Insurance Program clients about responsibilities, including payments schedules, and providing support to ensure timely payment.
Collecting Insurance Program client payments toward premiums, co-pays, and other patient-responsible portions and actively following up to secure payments.
Monitoring client progress and re-evaluating care plans.
Following DOH’s HIV/AIDS case management standard and guidelines including those outlining required eligibility redeterminations, use of CAREWare, and casefile documentation.
Maintaining a thorough knowledge and understanding of the Clients’ Rights and Responsibilities as well as all client services procedures.
Advocating on each client’s behalf in accessing needed services.
Recommending changes in case management policies and procedures.
Completing pre-intakes as required.
Maintaining and reporting caseload data as requested.
Maintaining assigned client files.
Performing other duties as assigned.
QUALIFICATIONS:
Case managers must have at least one of the following staff qualifications:
A bachelor’s degree in psychology, social work, or human services,
A bachelor’s degree in any field of study with at least six months of case management experience,
Applicable experience, which may be substituted on a year-for-year basis for the required education, or
A registered nursing license in Florida.
Must submit to and pass a level 2 background screening.
Must have reliable transportation.
PREFERRED QUALIFICATIONS:
Knowledge of HIV disease, government programs, and medical social work procedures.
Knowledge of health insurance assistance programs (e.g., ADAP, marketplace, COBRA, Medicaid).
Experience with benefits coordination, insurance premium assistance, or billing reconciliation.
Familiarity with 340B program principles and insurance payment interactions.
#J-18808-Ljbffr Big Bend Cares
Job Tags
Full time, Monday to Friday,