Qualis Home Health Services, LLC
Client Care Coordinator
Qualis Home Health Services, LLC, Woodbridge, Virginia, United States, 22195
Qualis Home Health Services is searching for passionate, reliable, amazingly experienced, and talented Client Care Coordinators to join our amazing team of in Northern Virginia and surrounding areas. The Client Care Coordinator at Qualis Home Health Services is the pillar of support from multiple levels within our office - this is a great opportunity to join a fast-growing company that prioritizes YOU!
Essential Functions Include (but are not limited to):
Referrals
Receive all new referrals to initiate the intake process (intake assessment form) Process incoming service authorization requests from various non-Medicare payer sources and ensure that such authorizations for service are in place for the first and subsequent episodes of treatment periods. Conduct relationship- building efforts with various referral sources. Oversee and maintain referral portal and conduct routine warm calling to convert a referral into a new client. Oversee all aspects of obtaining service authorizations as well as annual service authorization renewals. Conduct follow-up calls/emails as necessary with referral sources to ensure authorizations are approved in a timely fashion. Supervision
Serve as a point of contact of CAREStaff on assigned cases Communicate, on a routine basis, with various entitites, to maintain smooth relations and to obtain needed information Serve as the first point of contact for all Client/Family needs. Collaborate with clinical team of RN's/LPN's to schedule new client and renewal assessments and ninety (90) day routine assessments Ensure the client plan of care is effectively carried out. Schedule and conduct bi-annual supervisory spot visits. Ensure the completion and ongoing maintenance of client files. Conduct quarterly client file audits. Administrative
Process authorizations in portals such as WAMS and/or other means with MCO's via email/fax. Conduct routine insurance verifications of all new and current applicable cases to ensure eligibility of services. Oversee all aspects of obtaining service authorizations as well as annual service authorization renewals. Participate in both office and state-wide trainings. Ensure up-to-date with authorization protocols specifically as it relates to Medicaid Waivers and MCOs Perform data entry in various internal systems such as Trello as a communicative team tool. Oversee the scheduling of assigned clients on a ongoing basis. Perform quarterly chart audits for compliance and quality improvement measures Coordinate and communicate with PCP's for all Private Duty Nursing (PDN) authorizations to submit and ensure the completion of safety plans and CMS 485 forms etc. Submit requests for various safety plans as needed from the client/individual's PCP. Complete all assigned Medicaid Waiver quarterly reports, part V's, etc., and ensure copies are submitted in WAMS. Participate in ISP meetings (virtual and/or onsite). Create and maintain weekly and quarterly reports. Ensure that all new client forms such as the consent for treatment and service agreement are completed (either electronically or manually), and the completed documents are saved electronically or ensure the originals are manually completed and returned back to the office prior to the start of services.
Essential Functions Include (but are not limited to):
Referrals
Receive all new referrals to initiate the intake process (intake assessment form) Process incoming service authorization requests from various non-Medicare payer sources and ensure that such authorizations for service are in place for the first and subsequent episodes of treatment periods. Conduct relationship- building efforts with various referral sources. Oversee and maintain referral portal and conduct routine warm calling to convert a referral into a new client. Oversee all aspects of obtaining service authorizations as well as annual service authorization renewals. Conduct follow-up calls/emails as necessary with referral sources to ensure authorizations are approved in a timely fashion. Supervision
Serve as a point of contact of CAREStaff on assigned cases Communicate, on a routine basis, with various entitites, to maintain smooth relations and to obtain needed information Serve as the first point of contact for all Client/Family needs. Collaborate with clinical team of RN's/LPN's to schedule new client and renewal assessments and ninety (90) day routine assessments Ensure the client plan of care is effectively carried out. Schedule and conduct bi-annual supervisory spot visits. Ensure the completion and ongoing maintenance of client files. Conduct quarterly client file audits. Administrative
Process authorizations in portals such as WAMS and/or other means with MCO's via email/fax. Conduct routine insurance verifications of all new and current applicable cases to ensure eligibility of services. Oversee all aspects of obtaining service authorizations as well as annual service authorization renewals. Participate in both office and state-wide trainings. Ensure up-to-date with authorization protocols specifically as it relates to Medicaid Waivers and MCOs Perform data entry in various internal systems such as Trello as a communicative team tool. Oversee the scheduling of assigned clients on a ongoing basis. Perform quarterly chart audits for compliance and quality improvement measures Coordinate and communicate with PCP's for all Private Duty Nursing (PDN) authorizations to submit and ensure the completion of safety plans and CMS 485 forms etc. Submit requests for various safety plans as needed from the client/individual's PCP. Complete all assigned Medicaid Waiver quarterly reports, part V's, etc., and ensure copies are submitted in WAMS. Participate in ISP meetings (virtual and/or onsite). Create and maintain weekly and quarterly reports. Ensure that all new client forms such as the consent for treatment and service agreement are completed (either electronically or manually), and the completed documents are saved electronically or ensure the originals are manually completed and returned back to the office prior to the start of services.