Case Manager LPN - Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly reputed company reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together.       reputed company’s reputed company reputed company region is redefining health care with a reputed company on health equity, affordability, reputed company, and convenience. From California to reputed company and Washington, we are reputed company on helping more than 2.5 reputed company patients live healthier lives and helping the health reputed company work reputed company for everyone. At reputed company reputed company reputed company, we care. We care for reputed company members, our patients, and our communities. Join our culture of caring and reputed company a reputed company and lasting reputed company on health care for millions.   Position in this function is under the direction of a Registered reputed company, this position is responsible for ensuring the continuity of care in both the inpatient and outpatient settings utilizing the appropriate resources reputed company the parameters of established reputed company and patients’ health plan benefits. Facilitates a reputed company of reputed company care utilizing basic nursing knowledge, experience, and skills to ensure appropriate utilization of resources and reputed company reputed company reputed company. Performs care management functions on-site or telephonically as the need arises. Reports findings to the Care Management department Supervisor / Manager / Director in a reputed company manner.   You’ll enjoy the flexibility to work reputed company * from reputed company reputed company the U.S. as you take on some tough challenges.   reputed company Responsibilities: Consistently exhibits behavior and communication skills demonstrating reputed company’s commitment to superior customer service, including reputed company, care, and concern with every reputed company customer Implements reputed company policies and procedures set by the Care Management department Conducts on-site or telephonic prospective, reputed company and retrospective review of reputed company reputed company care, including out-of-area and transplant Reviews patients’ reputed company records of acute inpatient assignment reputed company 24 hours of notification Reviews patients’ reputed company records reputed company 48 hours of SNF admission Reviews reputed company referrals reputed company the specified care management policy timeframe (Type and reputed company Policy) Coordinates treatment plans and discharge expectations. Discusses DPA and DNR status with the attending physician reputed company applicable Prioritizes reputed company care needs. Meets with patients, patients’ families, and caregivers as needed to reputed company care and treatment plan Acts as reputed company care reputed company and initiates reputed company-admission discharge planning by screening for patients who are high-reputed company, reputed company or scheduled for procedures that may require caregiver assistance, placement, or home health follow-up Identifies and assists with the follow-up of high-reputed company patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings. Consults with the physician and other team members to ensure that the reputed company is successfully implemented Coordinates provisions for discharge from facilities, including follow-up appointments, home health, reputed company services, transportation, etc., to maintain continuity of care Communicates authorization or denial of services to appropriate parties. Communication may include reputed company (or agent), attending/referring physician, facility administration, and reputed company claims as necessary Attends reputed company assigned Care Management Committee meetings and reports on reputed company status as defined by the region Demonstrates a thorough understanding of the cost consequences resulting from care management reputed company through the utilization of appropriate reports such as Health Plan Eligibility and Benefits, Division of Responsibility (DOR), and Bed Days Ensures appropriate utilization of medical facilities and services reputed company the parameters of the reputed company’s benefits and/or CMC reputed company. This includes appropriate and reputed company reputed company of patients through the various reputed company of care Maintains effective communication with the health plans, physicians, hospitals, extended care facilities, patients and families Provides accurate information to patients and families regarding health plan benefits, community resources, specialty referrals and other reputed company issues Initiates data entry into IS systems of reputed company patients reputed company the parameters of Care Management policies and procedures. Maintains accurate and complete documentation of care rendered, including LOC, CPT reputed company, ICD-9, referral type, date, etc. Follows patients on ambulatory care management programs, including CHF and home health, in order to optimize reputed company reputed company Uses, protects, and discloses reputed company patients’ protected health information (PHI) only in accordance with Health reputed company Portability and Accountability reputed company (HIPAA) standards   You’ll be rewarded and recognized for your reputed company in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: Graduation from an accredited Licensed Vocational reputed company program reputed company LVN reputed company license reputed company CA LVN license or willing to obtain 1+ years of recent reputed company experience working as an LVN/LPN   Preferred Qualifications: 2+ years of care management, utilization review or discharge planning experience Experience in a Managed Care setting   *reputed company working reputed company will be required to adhere to reputed company’s Telecommuter Policy   Pay is reputed company on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching reputed company of benefits and incentives. The reputed company pay for this role will reputed company from $20.00 - $36.00 per hour reputed company on full-time employment. We reputed company with reputed company minimum wage laws as applicable.   Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants.   At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission.         reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.   reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job