Remote LPN Care Manager – Patient Advocate

Astrana Health Management; Northern (KY); Hybrid; USD 41,000 - 47,000; Full time

Job summary

Astrana Health is seeking a Care Manager I - LPN to join Health Services. This remote role is based in the Maryland area and requires LVN/LPN licensure with utilization management experience.

You will develop care plans, coordinate services, and advocate for patients within Medicare/Medicaid frameworks. The position emphasizes discharge planning, collaboration with physicians and nurses, and maintaining accurate clinical records while ensuring HIPAA compliance.

Qualifications

• Two (2) years’ utilization management experience applying evidence-based clinical criteria and benefit plans.
• Three (3) years’ clinical experience, preferably in case management or a related area.

Responsibilities

• Develop and initiate client-centred, comprehensive Individual Care Plans consistent with programme guidelines, policies and procedures.
• Identify, arrange and monitor appropriate community services, using strong knowledge of Medicare, Medicaid and other entitlement programmes.
• Coordinate and facilitate patient care through assessment, evaluation, planning and implementation, communicating needs to the care team and following up as required.
• Manage discharge plans and work collaboratively with patients, families, physicians and nurses to ensure high-quality care.
• Act as the patient’s advocate regarding insurance coverage and financial assistance.
• Maintain a comprehensive clinical record through detailed, accurate documentation.
• Coordinate an interdisciplinary approach to support timely access to appropriate care, ensure continuity among providers and optimise use of resources.
• Apply established care transition principles, following members through the continuum of care and coordinating warm hand-offs to appropriate providers and/or health plans.
• Assist the UM Manager and participate in all internal and external audits.
• Serve as primary liaison with contracted health plans for case management activities.
• Protect the privacy and security of PHI in line with Medical Group/MSO policies and HIPAA requirements.

Skills

Utilization management

Case management

Education

Bachelor's degree in nursing or related health services field

Job description

Astrana Health is seeking a Care Manager I - LPN to join Health Services. This remote role is based in the Maryland area and requires LVN/LPN licensure with utilization management experience.

You will develop care plans, coordinate services, and advocate for patients within Medicare/Medicaid frameworks. The position emphasizes discharge planning, collaboration with physicians and nurses, and maintaining accurate clinical records while ensuring HIPAA compliance.