Care Manager-LPN

Pediatric Associates Family of Companies; United States; Remote; USD 75,000 - 85,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

401(k)

Paid paternity leave

Paid maternity leave

Job summary

A children's healthcare organization is looking for a Care Manager-LPN to assist in care coordination for medically fragile pediatric patients. This role involves collaboration with healthcare teams, conducting assessments, and ensuring proper care delivery. An ideal candidate will have experience as an LPN/LVN and expertise in care management. This position is remote but requires U.S. residency. Competitive salary and comprehensive benefits are offered.

Qualifications

• Minimum 3 years healthcare experience required as LPN/LVN.
• Care management experience is preferred.
• Licensure as an LPN/LVN or higher is essential.

Responsibilities

• Conduct assessments of medically complex pediatric patients.
• Collaborate with healthcare teams to identify patient needs.
• Document care management activities and plans.

Skills

Interpersonal skills

Decision-making skills

Analytical skills

Education

Associate degree or two years’ technical schooling

Tools

Electronic health record systems

Job description

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 level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Paid paternity leave

Paid maternity leave

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