Licensing Specialist
Company Name
**
BENTON, KY, US
Basic
Posted 6 days ago
Our Company
StepStone Family & Youth Services
Overview
The Licensing Specialist is responsible for the recruitment of Foster/Adoptive Parents. The Licensing Specialist will develop territories, increase target populations, develop sales plans, develop rapport with potential candidates, and help increase awareness of the need for caregivers in the community. The Licensing Specialist is also responsible for caregiver initial state licensing, recertification/approval of the foster/adoptive license, and providing, facilitating, logging, and tracking all caregiver training.
Responsibilities
Coordinate and engage in recruitment and awareness activities to recruit prospective foster/adoptive parents and build community awareness relations
Develop and implement proactive, strategic recruitment plans designed to attract and certify qualified candidates, while maintaining a pipeline of both active and passive candidates for future training and certification
Respond to foster parent inquiries within 24 hours via phone
Develop strategies to support efforts for general, targeted and child-specific recruitment and marketing
Understand and follow all agency and state licensing requirements and always ensure foster parents’ compliance with regulations
Assist with and complete the certification process with foster parents, including the completion of required documentation
Complete parent interviews, background clearances, and home inspections to evaluate suitability, safety, and well-being of youth placed in the homes.
Maintain foster parent files in compliance with agency and state regulations
Assist in the placement process and successful matching of youth and foster parents based on the needs of referred youth and the level of training, strengths, and expertise of the foster family
Maintain professional boundaries, conduct, confidentiality and other governmental laws and regulations, agency policy and licensure ethics
Attend all company required meetings, in addition to community meetings to provide on-going collaboration with referral sources and community providers
Provide support to all members of the treatment team, including case manager, therapist, foster parents, and youth to ensure needs are met and ensure placement stability
Ensure safety and well-being of all youth in care by observing for signs of abuse and/or neglect
Travel to affiliate locations; frequent travel associated with recruitment events required
Participate in the developmental implementation of Corrective Action Plans for foster parents in conjunction with the program supervisor
Provide services that respect each family and youth’s cultural background, heritage and identity
Conduct Monthly Foster Parent record reviews; 25% each month
Conduct Monthly Foster Parent Meetings and monthly Foster Parent trainings
See children in home once monthly, at a minimum, as needed
Create and maintain child files and complete monthly reports for each child, as needed
Qualifications
A bachelor’s degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology, or other human service, behavioral science field or public administration field
Minimum of one year of work experience in a Child Placing Agency, the Department of Family and Children Services, or Non-Profit Agency
One to two years of Experience in Resource Development/ Foster Parent Recruitment and Retention preferred
One year of marketing, fundraising, and event coordination preferred
One to five years’ experience in full cycle recruiting in a fast paced, professional oriented environment preferred
Complete Tier 1 and Tier 2 State Assessor training and maintain Assessor certification
Have a strong recruiting mentality and a general understanding of a recruiting life cycle from sourcing/lead generation to filling positions
Demonstrate knowledge of vast recruiting strategies, including social media platforms
Strong attention to detail, highly organized, highly energetic, and positive and encouraging attitude
Effective at cold calling, pursuing leads, and transforming candidates into licensed caregivers
Ability to remain client focused and use independent judgement in problem solving required Strong interpersonal skills
Strong project management, new business development and client retention skills a must
A documented track record of achieving targeted objectives is required.
Possess critical thinking skills, supported by intellectual curiosity and sound business judgment
Outstanding telephone presence and superior written communication skills; team player and natural leader; competitive
About our Line of Business StepStone Family and Youth Services, an affiliate of BrightSpring Health Services, provides the full spectrum of support to children in need of alternative, safer, and more positive living environments with residential and family services. StepStone connects children and youth who need homes with foster families, as well as foster care training, respite care and support services. For young adults transitioning from foster care to independent living, StepStone provides personalized guidance and training on basic life skills, including money management and education. For more information, please visit www.stepstoneyouth.com. Follow us on Facebook and LinkedIn.
Salary Range USD $46,000.00 - $47,000.00 / Year
Provider Network Manager
Company Name
**
LOUISVILLE, KY, US; LEXINGTON, KY, US; BOWLING GREEN, KY, US; MEMPHIS, TN, US; NASHVILLE, TN, US; CHATTANOOGA, TN, US
Basic
Posted 11 days ago
Our Company
Abilis Health Plan
Overview
The Provider Network Manager is responsible for maintaining and enhancing provider networks within an assigned territory through provider relations, network development, and routine contracting activities. The Provider Network Manager serves as a primary contact for contracted providers, conducts provider education and outreach, identifies and addresses network opportunities, and supports provider recruitment efforts. The position also monitors market changes and network performance to ensure adequate provider coverage and compliance with CMS network adequacy standards and all applicable regulatory requirements.
Responsibilities
Manage provider relationships within assigned markets, serving as a primary point of contact for contracted providers and addressing network-related issues and inquiries.
Perform routine provider contracting and recruitment activities to support network growth, address coverage gaps, and maintain adequate provider access.
Conduct provider education and outreach activities to promote provider engagement, communication, and understanding of health plan requirements and initiatives.
Monitor and report market and provider changes that may impact network performance, access, or compliance within assigned territories.
Collaborate with internal departments to resolve provider issues, support operational initiatives, and improve network effectiveness.
Promote a positive and collaborative work environment that supports continuous improvement and organizational success.
Complete all assigned corporate responsibilities, including compliance training and other organizational requirements.
Qualifications
Associate’s Degree or equivalent work experience.
Five (5)+ years of experience in managed care, provider network development, provider relations, contracting, or a related healthcare field.
Prior experience with Medicare Advantage plans required; Institutional Special Needs Plan (I-SNP) experience preferred.
Experience building and maintaining provider relationships, conducting provider education, and supporting provider engagement initiatives.
Reliable transportation.
Current automobile insurance which meets company policy requirements.
Familiarity with health plan operations, including benefits, claims review and resolution, eligibility, provider data management, and network operations.
Knowledge of CMS network adequacy standards, provider recruitment, and regulatory compliance requirements preferred.
Strong organizational, presentation, and time management abilities.
Effective communication skills.
Working knowledge of Medicare payment methodologies.
Ability to follow instructions and work independently to achieve goals and complete assignments.
Proven success working collaboratively in a team environment.
Proficient in Microsoft Office Suite and other relevant computer applications.
Self-motivated, dependable, team-oriented, and goal-oriented.
Skilled at managing multiple priorities effectively.
Travel up to 25%
About our Line of Business Abilis Health Plan, an affiliate of BrightSpring Health Services, is a Medicare Advantage Plan covering all the benefits of Original Medicare (Parts A and B) with prescription drug coverage (Part D). The Abilis Health Plan is a unique plan allowing members to enroll year-round. The plan focuses on members who meet residential requirements in participating nursing facilities. An interdisciplinary team of clinicians and innovative services allow us to meet each member’s clinical needs and provide preventive, coordinated, and quality healthcare. With a dedicated nurse practitioner leading a personalized care plan, we strive to improve the health of the communities in which we serve. For more information, please visit www.abilishealth.com. Follow us on LinkedIn.
Salary Range USD $70,000.00 - $80,000.00 / Year
Health Payer Escalated Contract and Billing Specialist
Company Name
**
LOUISVILLE, KY, US
Basic
Posted 11 days ago
Our Company
BrightSpring Health Services
Overview
Key responsibilities include ability to interpret complex health insurance contracts, understand billing processes, and effectively communicate and resolve escalated payment issues with insurance carriers working within the billing and contracting teams.
Responsibilities
Contract & Benefit Interpretation: Review and apply health insurance contracts to billable services, benefit policy terms, and coverage limitations to determine eligibility and payment eligibility for claims per contract expectations according to benefit parameters.
Demonstrate billing process expertise to identify and address escalated payment issues as a result of internal billing discrepancies.
Investigate and resolve escalated payment disputes, including denied, underpaid, or delayed claims, by coordinating with health insurance contract stakeholders as well as internal stakeholders.
Build data-driven cases to support, justify, and advocate for escalated claims payments.
Able to review claims submission for internal errors creating escalated payment issues and communicating those details
Qualifications
Bachelor’s degree in related field preferred
Experience or strong understanding in contracting & contract management
Experience in medical or insurance billing with a track record of resolving escalated payment issues.
Proficiency in billing software, EHR systems, and claims submission platforms.
Experience of or strong understanding of ICD-10, CPT, modifiers, and insurance payment terms.
Experience with MPPR/Sequestration, coinsurance and Deductibles
Coding Certification a plus
Excellent time management, prioritization and organizational skills
Experience in Outlook, Word, and PowerPoint desired
Detail-oriented with strong organizational and problem-solving abilities
Self-motivated and results oriented
Proficiency in Microsoft Office applications, including Excel, Word and PowerPoint
Excellent verbal and written communication and presentation skills
Mininmal travel
About our Line of Business BrightSpring Health Services provides complementary home- and community-based health solutions for complex populations in need of specialized and/or chronic care. Through the Company’s service lines, including pharmacy, home health care, and rehabilitation, we provide comprehensive and more integrated care and clinical solutions in all 50 states to over 475,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and industry-leading quality metrics across its services lines, while improving the health and quality of life for high-need individuals and reducing overall healthcare system costs. For more information, please visit www.brightspringhealth.com. Follow us on Facebook, LinkedIn, and X.
Pharmacy Inventory Specialist
Company Name
**
LOUISVILLE, KY, US
Basic
Posted about 1 month ago
Our Company
PharMerica
Overview
PharMerica , a part of Brightspring Health Services, is a long‑term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.
As a a non-retail pharmacy , we focus on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation facilities, long-term acute care centers, and other specialized care centers nationwide. Our organization is in high growth mode, which can provide opportunities for advancement for individuals looking for career progression!
The Pharmacy Inventory Specialist will work closely with the Pharmacy Technician Supervisor, Pharmacy Fulfillment Manager, Pharmacy Director, and the Director of Procurement to ensure all aspects of inventory management at the pharmacy level are complete and accurate. Included in responsibilities are Inventory counts, cycle counts, receiving, ordering, monitoring out-of-stock medications by looking into queues for upcoming patient orders. This would also include managing returns and transfers from pharmacy to pharmacy, and other duties as assigned.
The ideal candidate will be a Registered Pharmacy Technician with two or more years in a Pharmacy or Healthcare Setting
Remote: May live anywhere within the Continental USA
Schedule: Monday - Friday 9:00am to 6:00pm
Travel: up to 25%
Benefits and perks for you!
Medical, Dental, Vision insurance
Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)
Tuition discounts & reimbursement
401(k)
Company Paid Time Off*
Shift Differential
DailyPay
Pet Insurance
Employee wellness and discount programs
Responsibilities
Participates in orientation, training, and competency assessment
Manages the medication return processes including manufacturer returns and replacement product
Receives drugs and supply orders, stock shelves, rotates stock using FEFO, and removes outdated drugs from inventory
Monitors inventory levels of supplies and drug specific care kits to ensure compliance with SOPs
Manages inventory out-of-stocks communicating with purchasing as necessary
Completes cycle counts as well as physical inventory and investigate/resolve any active variance
Ensures all intercompany pharmacy transfers are completed as requested in a timely manner
Maintains a clean and safe pharmacy work environment by complying with policies, procedures, and regulations
Organizes medications for pharmacist to dispense by reading medication orders and prescriptions; preparing labels; calculating quantities
Monitors any communications between patients and physician offices to coordinate any deliveries that are delayed
Ensures packing all deliveries are as per SOPs, including seasonal cold chain packing to protect product integrity
Understands USP 800 guidelines and follows safe handling of hazardous materials
Escalates workflow/process improvement ideas to leadership
Contributes to team effort by accomplishing related tasks as needed
Performs other tasks as assigned
Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
Qualifications
High School Diploma or GED equivalent; Certified Pharmacy Technician, Associates, or Bachelor’s Degree desired
Two or more years in a Pharmacy or Healthcare Setting
Previous leadership experience is a plus
Pharmacy or Health Care related knowledge, data entry experience in conjunction with pharmacy; Specialty
Pharmacy leadership experience preferred
Registration with Board of Pharmacy; Certified Pharmacy Technician (PTCB)
Deadline oriented, strong time management and prioritization skills as well as an independent worker
About our Line of Business PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.