Care Management Support Specialist

About Us

A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. Through a combination of in-person home visits, remote coaching and our proprietary digital collaboration app, we provide caregivers with support, guidance, confidence, and connection to resources they need. The Caregivers and families we support stay with Careforth for many years, building lasting relationships along the way. Join us today and live our values: lead with heart, cultivate trust, go beyond.


Position Summary

Reporting to the Manager, Care Management, the Care Manager Support Specialist (CMSS) is responsible for a wide array of administrative and operational activities to support care management team(s). The CMSS will assist the Manager and care teams with care coordination, community resource referrals, internal audits, and ongoing compliance with credentialing and state requirements. In addition, the CMSS will help to ensure timely communication with internal/external stakeholders in support of the delivery of care management service delivery.


What You Will Do

• Assist the Care Management team with internal and external communication, including making referrals for community resources as requested by the care team.
• Assist the team with caregiver credentialing and caregiver expirables that are required per regulation.
• Assist with tracking authorizations for continued service delivery.
• Review denied and ineligible reports from the medical billing team; Work with appropriate stakeholders to assist with claim resolution and update systems of record where applicable
• Monitor and manage emails and phone calls related to the Structured Family Caregiving and Shared Living programs; Follow-up with care team members and provide documentation to relevant parties as needed
• Run routine reports within Salesforce (e.g. compliance tasks, census, open incidents, IOS, etc.) and provide updates to care teams and managers as needed.
• Utilize dashboards and reports within the case management system to drive efficient outcomes and understand trends (e.g. obtaining timely authorizations, managing referrals, branch timeliness)
• Assist with compliance audits, both internal and external
• Assist with caregiver and team technology-related issues as they arise
• Occasional travel to a caregiver's home may be required.
• Perform other projects and duties as assigned

What You Will Bring

• 2-4 years of experience in an operations or administrative role, preferably in a case management or healthcare setting
• Proficiency in Microsoft Office Suite (Excel, Word, Outlook)
• Strong communication skills, excels in professional interactions by phone and writing
• Strong attention to detail and experience with data integrity in a regulated environment
• Strong business acumen with desire to understand end to end business operations

You'll Benefit From

At Careforth your well-being matters. With flexible schedules, a remote-first culture, and a nationally recognized wellness program, our benefits are designed to help you thrive, both professionally and personally. Discover how we invest in you:

The pay range for this position is $39,542 - $53,415. The actual wage offered may be lower or higher depending on budget and candidate experience, knowledge, skills, qualifications, and geographic location.


Join Our Award Winning Team

Founded in Boston, Careforth's caregiver programs and services improve health outcomes, keeping care at home longer. Additionally, our programs provide financial benefit to caregivers and cost savings to state agencies and health plans. At Careforth, we understand the challenges of caregiving and are committed to supporting family caregivers at every turn.

Caregivers play a critical role in the future of healthcare-and so can you.

Apply now!

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Careforth is an Equal Opportunity Employer*

DISCLAIMER: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.

*Careforth supports families with diverse backgrounds and as an equal opportunity employer, we seek employees who reflect the diverse population we serve. Careforth complies with all applicable laws concerning hiring and employment practices and is firmly committed to fostering and maintaining a workplace free from discrimination. We pledge to hire, train, and promote our employees without regard to race, religion, gender, gender identity, genetic information, age, national origin, sexual orientation, disability, veteran status, or any other category protected by applicable law.

Careforth strives to create experiences that are accessible and welcoming to everyone, including making and the careers site accessible to any and all users. If you would like to contact us regarding the company's diversity, equity and inclusion initiatives, inquire about a specific accessibility need or the accessibility of our website, or if you need assistance completing an application process, please contact People & Culture at View phone number on click.appcast.io.