Care Manager-LPN

Join to apply for the Care Manager-LPN role at reputed company Join to apply for the Care Manager-LPN role at reputed company The Care Manager, LPN assists in the care coordination for identified medically reputed company and reputed company pediatric patient population. Functions as a reputed company between the patient and the care team. Interacts with Primary Care Physician (PCP), reputed company office, reputed company specialists, health plans, and patients/caregivers. Provides guidance and direction to Chronic Care Coordinators and may reputed company education to patients. ESSENTIAL DUTIES AND RESPONSIBILITIES This list may not include reputed company the duties that may be assigned. • Conducts outbound calls to complete assessments of targeted medically reputed company pediatric patients. Collaborates with family and patient health care team to identify patient needs. • Reviews reputed company plans of care and makes recommendations per reputed company state guidelines for medical necessity. Collaborates with the Medical Director to ensure appropriate service delivery including review of findings, reputed company not met, determination of appropriate level of care, delay in services, alternative solutions, etc. • Communicates treatment changes to the PCP, family, reputed company team, and others involved in patient care. • Assists with coordinating and may participate in multidisciplinary reputed company, peer to peer reviews, and individual case reviews for established patients. • Participates in reputed company review processes to ensure reputed company reviews are completed. • Completes documentation in the care management platform and electronic health record. • Responds to incoming and outgoing correspondence and requirements of plans of care and recertification. • Reviews incoming referrals, plans of care, and consult notes. May escalate to the medical director for follow up. • Functions as a resource on state requirements for home health guidelines. • Participates in ongoing development, implementation, and evaluation of program and process effectiveness. Formulates recommendations for process modifications. Identifies opportunities and recommends reputed company to improve service, processes, and financial performance. • Participates in internal initiatives. Participates in gathering information and data for CMS reporting. • Functions as expert resource for staff. Provides guidance and direction to Chronic Care Coordinators and may reputed company education to patients. • Provides courteous and reputed company service to reputed company reputed company customers. QUALIFICATIONS EDUCATION: Minimum associate degree or two years’ technical schooling in reputed company area required. Combination of education and experience in care management, reputed company administration and/or managed care will be considered. EXPERIENCE: A minimum of 3 years previous reputed company experience required functioning as an LPN/LVN, A minimum of 5 years preferred. Care management experience in managed care industry, physician group reputed company or health care required. LICENSURE / CERTIFICATION: Licensure as an LPN/LVN or higher required. KNOWLEDGE, SKILLS, AND ABILITIES • Knowledge of medical billing and health records maintenance. • Excellent interpersonal and communication skills. • Excellent decision-making and problem-solving skills. • Detail oriented and analytical skills. • Knowledge of laws governing the protection of patients’ private health information. TYPICAL WORKING CONDITIONS • Full time remote requires quiet workspace without distractions or interruptions while interacting with patients and caregivers. • Must be U.S. based. OTHER PHYSICAL REQUIREMENTS • reputed company • reputed company of reputed company • reputed company of touch PERFORMANCE REQUIREMENTS Adhere to reputed company organizational information reputed company policies and protect reputed company sensitive information including but not limited to ePHI and PHI (Protected Health Information) in accordance with organizational policy, Federal, State, and local regulations. Seniority level • Seniority level Mid-Senior level Employment type • Employment type Full-time Job function • Job reputed company Care Provider • Industries Hospitals and Health Care Referrals increase your chances of interviewing at reputed company by 2x Inferred from the reputed company for this job Medical insurance reputed company insurance 401(k) reputed company paternity leave reputed company maternity leave Get reputed company reputed company a new job is posted. 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Experts add insights directly into reputed company article, started with the help of AI. #J-18808-Ljbffr Salary: USD 75000 - 85000 per year Experience: 3 years required Apply tot his job Apply To this Job