Part Time Prior Authorization Jobs in Ohio (NOW HIRING)

Started in 2016, FreedomCare is a Healthcare company that is innovating and revolutionizing the way home care is delivered. We bring dignity and support to patients needing care in their homes and to the caregivers who care for them. We're the largest consumer-directed home care agency in NY State, and are continually expanding our areas of focus including operations in other states and tech-based innovations.  

We pride ourselves on our values which drive the level of care that we deliver to our patients:

• Here For You (An attitude of service, empathy, and availability)
• Own It (Drive and ownership)
• Do the Right Thing (High integrity)
• Be Positive (Great attitude and a can-do positive approach to challenges)

Join our team and make a positive impact on the lives of others! We are looking for a  Part Time Licensed Social Worker (LSW) for our team in Ohio.

This is a part time, hybrid role with required fieldwork and a commute to our FreedomCare office in Cleveland, OH at least two times a month. 

Department & Position Overview: 

The Licensed Social Worker role will be essential to our Structured Family Caregiving (SFC) program, within the state of Ohio.  

SFC is a caregiving arrangement in which a patient lives with a principal caregiver who provides daily support based on the patient's daily care needs. The goal of this service is to provide necessary care while fostering and emphasizing the patient's independence in a home environment that will provide them with a range of care options as their needs evolve. The service is designed to provide options for alternative long-term care to persons who meet nursing facility-level care needs while preserving the dignity, self-respect, and privacy of the patient. 

As the Licensed Social Worker, you will be responsible for oversight of our patients' care by providing continued support to both the patient and caregiver; serving as both the escalation point and advocate for quality of service with FreedomCare and the SFC program. 

Every Day You Will:

• Interpret the philosophy and objectives of the agency to clients, families, and others. 
• Ensure that compliance needs are met, in adherence with; HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant policies of the provider, policies/procedures as administered by FreedomCare, as well as any state or federal mandates.  
• Conduct initial in-person home assessments with the patient and the caregiver to ensure compliance needs are met and that the plan of care is in place and clearly communicated.  
• Provide day-to-day monitoring with monthly contact with both the patient and caregiver, as it relates to: 
• Patient enrollment [credentialing, claims operations, prior authorization appeals, etc.] and patients' satisfaction with care delivery and caregiver support [ensure program integrity and reporting related to the SFC programs and the ability to triage issues to the appropriate internal staff]. 
• Quality of service is within the required plan of care, providing; individualized coaching, continued education, and review the caregivers goals and needs to support continued enhancement of competencies. 
  • *Contacts may be a combination of telephonic and in-person visits, with no more than sixty calendar days between in-person visits. 
• Maintain detailed and accurate case records, documenting significant changes and observations, inclusive of but not limited to written records, reports, and notes in accordance with agency policy and procedure following client visits or contacts in an accurate, timely, complete, concise and legible manner. 
• Act as the point of escalation and provides input to the client's plan of care to include the physician's plan of treatment as well as problem list, implementing and monitoring any changes as necessary.  
• Perform other job-related duties as may be required or directed by the supervisor. 

Education and Experience:

• Valid and active Ohio Licensed Social Worker license, issued by the CSWMFT Board.  
• Bachelor's degree (BSW) or Master's degree (MSW) in Social Work from a CSWE-accredited program 
• Minimum of 2 years clinical experience, 1 year of experience with elders or adults with disabilities  
• Home care experience a plus 
• Bilingual in Spanish is a plus 
• Experience with CRM (Salesforce is a plus) 
• Valid driver's license with an insured vehicle for travel within the state 

Qualifications:

• Demonstrated success driving operational excellence by effectively evaluating operational tasks as well as setting, achieving and measuring targeted outcomes, in a hybrid and field-based environment.  
• A high level of adaptability and experience in case management, with a fast-paced environment, presenting a high degree of autonomy, ambiguity, and accountability.  
• Excellent verbal and written communication, with the ability to effectively cascade information across diverse target demographics internally and externally.  
• Ability to represent FreedomCare holistically, with high emotional intelligence, empathy, and consciousness of end-user experiences (employees and customers). 
• Experience using a CRM (Salesforce is a plus) 

Why work at FreedomCare?

We are here for you and committed to providing a best-in-class employee experience. We offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events and ongoing learning opportunities to grow your career.

This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others!

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.
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