Client Care Specialist

Client Care Specialist - National Care Team, under the direction of the Director, National Care Team, is responsible for coordinating and overseeing the delivery of care and service to insurance funded clients. Under the guidelines of the National Insurance Program, he/she ensures compliance with internal and external standards of practice. In keeping with the organizational structure of the department, this individual assumes overall responsibility for specific operations in the absence of the Manager, Extended Health Insurance Program. DUTIES AND RESPONSIBILITIES

• Oversees/Assists in the implementation of managed care for Bayshore's National Insurance Programs
• Intakes new referrals from insurance companies and distributes to the appropriate branch
• Intakes referrals from branches, and investigates insurance coverage as appropriate
• Tracks each referral for timeliness of contact, assessment, etc.
• Provides ongoing high level of communication to key contacts/customers - internal & external
• Liaises between branch and insurer to obtain authorization for services, advises changes to client status, etc.
• Assists branches in following insurance specific protocols related to documentation, billing, etc.
• Maintains client records within National Insurance Department
• Maintains computerized tracking system to track all referrals
• Monitors/advises branches of reassessment due dates
• Cultivates/builds effective relationships with key contacts in insurance
• Cultivates/builds effective relationships with key contacts in Bayshore branches
• Assists in the development of insurance related programs, presentations, etc.
• Participate in business development as appropriate
• Lead or assist with the integration of client satisfaction initiatives; ensure that all client concerns/complaints are satisfactorily addressed/documented
• Assumes responsibility for specific department operations in the absence of Director, National Care Team
• Participate in ongoing internal and/or external continuing education activities
• Adhere to Bayshore Policies and Procedures
• Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System
• Participates in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns. Responsible for completing Accident Reports for all direct reports who injure themselves on the job, within 24 hours of the incident.
• Maintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel
• Complete other tasks as requested

Job Qualification

Education:

Graduation from a College or University level accredited program - community related studies. Experience:

At least two years of previous work experience in a community setting; experience in working in a supervisory capacity; demonstrated ability to handle all aspects of human resources; experience in business development preferred. Other Skills and Abilities:

Exceptional interpersonal skills and the ability to handle difficult situations in an objective and consistent format; ability to work independently as well as effectively as a member of a team; above average report writing and communication skills; solid knowledge of the principles, practices, and methods of community nursing, and service delivery to clients, as well as program development, implementation and evaluation.