Care Manager-LPN

Join to apply for the Care Manager-LPN role at Pediatric Associates Family of Companies

Join to apply for the Care Manager-LPN role at Pediatric Associates Family of Companies

The Care Manager, LPN assists in the care coordination for identified medically fragile and complex pediatric patient population. Functions as a liaison between the patient and the care team. Interacts with Primary Care Physician (PCP), front office, outside specialists, health plans, and patients/caregivers. Provides guidance and direction to Chronic Care Coordinators and may provide education to patients.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all the duties that may be assigned.
• Conducts outbound calls to complete assessments of targeted medically complex pediatric patients. Collaborates with family and patient health care team to identify patient needs.
• Reviews current plans of care and makes recommendations per current state guidelines for medical necessity. Collaborates with the Medical Director to ensure appropriate service delivery including review of findings, criteria not met, determination of appropriate level of care, delay in services, alternative solutions, etc.
• Communicates treatment changes to the PCP, family, healthcare team, and others involved in patient care.
• Assists with coordinating and may participate in multidisciplinary rounds, peer to peer reviews, and individual case reviews for established patients.
• Participates in quality review processes to ensure active 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 methods 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 provide education to patients.
• Provides courteous and prompt service to all internal and external customers.

QUALIFICATIONS

EDUCATION: Minimum associate degree or two years’ technical schooling in related area required. Combination of education and experience in care management, practice administration and/or managed care will be considered.

EXPERIENCE: A minimum of 3 years previous healthcare experience required functioning as an LPN/LVN,

A minimum of 5 years preferred. Care management experience in managed care industry, physician group practice 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
• Vision
• Sense of sound
• Sense of touch

PERFORMANCE REQUIREMENTS

Adhere to all organizational information security policies and protect all 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 levelEmployment type
• Employment type
Full-timeJob function
• Job function
Health Care Provider
• Industries
Hospitals and Health Care

Referrals increase your chances of interviewing at Pediatric Associates Family of Companies by 2x
Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Paid paternity leave

Paid maternity leave

Get notified when a new job is posted.
Sign in to set job alerts for “Care Manager” roles.

United States $75,000.00-$85,000.00 3 weeks ago

United States $80,000.00-$85,000.00 1 week ago

United States $55,100.00-$99,000.00 1 week ago
Customer Care Associate/Manager, Fashion & Lifestyle E-Commerce

Florida, United States $55,100.00-$99,000.00 1 week ago

United States $65,000.00-$80,000.00 2 weeks ago

Florida, United States $55,100.00-$99,000.00 1 week ago

Florida, United States $55,100.00-$99,000.00 1 week ago
Customer Success Manager - Digital Health

United States $42,872.55-$55,734.32 3 weeks ago

Florida, United States $55,100.00-$99,000.00 1 week ago

California, United States $65,000.00-$85,000.00 1 month ago

United States $97,325.00-$114,500.00 4 hours ago

Florida, United States $65,000.00-$85,000.00 1 month ago

Massachusetts, United States $65,000.00-$85,000.00 1 month ago

West Palm Beach, FL $55,100.00-$99,000.00 1 week ago

Hawaii, United States $65,000.00-$85,000.00 1 month ago

West Palm Beach, FL $55,100.00-$99,000.00 1 week ago

Oregon, United States $65,000.00-$85,000.00 1 month ago

West Palm Beach, FL $55,100.00-$99,000.00 1 week ago

United States $55,100.00-$99,000.00 1 week ago

Connecticut, United States $65,000.00-$85,000.00 1 month ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each 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