Nurse Case Manager - Case Management Nurse - LPN​/LVN

16 hours ago Be among the first 25 applicants

Direct message the job poster from Lance Soft Inc.,

Duration: 5+ months with possible extension

Est. Pay Range: $29.00/hr. to $32.00/hr.

Schedule: M-F 8-5

Position Summary

• Complete health screening questionnaires, assessments which may be market specific.
• Support reduction of population of unable to reach members by telephone and in
  -person visits.
• Ensure member has filled/received their medication(s) and has an understanding on how to take their ordered medications.
• Manage caseload of members with current stratification of monitoring, low and medium or those with high social determinants of care needs- frequency /contract guidelines
• Provides clinical assistance to determine appropriate services and supports due to member’s health needs (including but not limited to:
  Prior Authorizations, Coordination with PCP and Specialty providers, Condition Management information and education, Medication management, Community Resources and supports)
• Evaluation of health and social indicators
• Identifies and engages barriers to achieving optimal member health.
• Uses discretion to apply strategies to reduce member risk.
• Presents cases at case conferences for multidisciplinary focus to benefit overall member management.
• Facilitates overall care coordination with the care team to ensure member achieves optimal wellness within the confines of the member’s condition(s) and abilities to self-manage.
• Coordinates resources, assists with securing DME, and helps to ensure timely physician follow-up.
• Understands Payer/Plan benefits, policies, procedures, and can articulate them effectively to providers, members, and other key personnel.
• Updates the Care Plan for any change in condition or behavioral health status.
• Provide support to members in transitions of car

Duties:

• Responsible for interacting with low stratification members via phone calls, coordinating care, completing, reviewing, and updating assessments and care plans that address problems, goals, and interventions.
• Based on assessments and claims data creates a care plan for members to follow 70%
• Participate as a member of the Care Team during Interdisciplinary Team meetings to discuss the member’s health care needs, barriers to care and explore better outcomes for the member 20%
• Identify and link members with health plan benefits and community resources 5%
• Perform administrative work to maintain skills needed for job duties 5% 5%

Experience:

• Required:
  
  2 years LPN Nursing exp, preferred 3 + year’s experience.
• Regular and reliable attendance
• Familiar with community resources & services
• Strong organizational skills
• Works independently.
• Maintains professional relationships with the members we serve as well as colleagues.
• Communicates effectively and professionally verbally and in writing.
• Proficient with computer systems
• Knowledgeable in Microsoft Office Software
• Has a dedicated homework space

Education:

• HS or equivalent, must be licensed LPN.

Employee Benefits:

At Lance Soft, full time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:

• Four options of medical Insurance
• Dental and Vision Insurance
• 401k Contributions
• Critical Illness Insurance
• Voluntary Permanent Life Insurance
• Other Employee Perks

Seniority level

• Seniority level
  
  Entry level

Employment type

• Employment type
  
  Full-time
• Industries
  
  IT Services and IT Consulting

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