LPN Case Manager: Care Coordination & Utilization Review

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

Job summary

MedStar Health’s Washington Hospital Center is seeking an experienced LPN Case Manager to support the Care Management Department by coordinating quality, cost-effective care.

The role requires 1–2 years utilization review experience and 3–4 years diverse clinical experience; valid Maryland/DC LPN license; you will interact with providers, obtain clinical information, process pre-authorizations, and maintain IS system documentation.

Qualifications

• Valid LPN license in Maryland or DC; required at hire.
• 1-2 years utilization review experience; 3-4 years diverse clinical experience.
• Ability to use a computer to enter and retrieve data; experience with Word/Excel/PowerPoint preferred.

Responsibilities

• Assist in identifying candidates and refer appropriately.
• Coordinate benefits coordination and quality/utilization processes.
• Obtain clinical information from providers to support care and pre-certifications.
• Maintain timely documentation in the IS System per policy.
• Process pre-authorizations for medical necessity and covered benefits.

Skills

Utilization review knowledge

Clinical experience

Computer skills

MS Office suite

Education

LPN license - Maryland or DC

Tools

IS System

Microsoft Office

Job description

MedStar Health’s Washington Hospital Center is seeking an experienced LPN Case Manager to support the Care Management Department by coordinating quality, cost-effective care.

The role requires 1–2 years utilization review experience and 3–4 years diverse clinical experience; valid Maryland/DC LPN license; you will interact with providers, obtain clinical information, process pre-authorizations, and maintain IS system documentation.