LPN Case Manager: Care Coordination & Utilization Review

MedStar Health; Washington (District of Columbia); On-site; USD 45,000 - 74,000; Full time

Job summary

MedStar Health is seeking an LPN Case Manager in the Washington, DC area to coordinate and promote quality, cost-effective care within the Care Management Department. The role supports provider interactions, pre-certifications, and benefits coordination while maintaining accurate documentation.

Required is a Maryland/DC LPN license with 1–2 years of utilization review and 3–4 years of diverse clinical experience. The position emphasizes adherence to regulations and patient care philosophy.

Qualifications

• Valid LPN license in Maryland or DC required.
• 1–2 years utilization review experience.
• 3–4 years diverse clinical experience.
• Knowledge of current healthcare delivery and utilization review criteria.
• Ability to use computer to enter and retrieve data.

Responsibilities

• Identifies potential Case Management candidates and makes referrals.
• Contributes to department goals and adheres to policies and standards.
• Maintains documentation in the IS system per policy.
• Coordinates pre-authorizations for medical necessity and benefits.
• Interacts with disease management populations to improve access to care.

Skills

Utilization review

Communication

Documentation

Healthcare knowledge

Education

LPN license Maryland/DC

Tools

Word

Excel

PowerPoint

Job description

MedStar Health is seeking an LPN Case Manager in the Washington, DC area to coordinate and promote quality, cost-effective care within the Care Management Department. The role supports provider interactions, pre-certifications, and benefits coordination while maintaining accurate documentation.

Required is a Maryland/DC LPN license with 1–2 years of utilization review and 3–4 years of diverse clinical experience. The position emphasizes adherence to regulations and patient care philosophy.