Care Manager I – LPN

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Develop and implement client-focused, detailed Individual Care Plans.

• Identify, organize, and oversee suitable community services.

• Coordinate and facilitate patient care through assessment, evaluation, planning, implementation, communication, and follow-up.

• Manage discharge plans while collaborating with patients, families, physicians, and nurses.

• Advocate for patients concerning insurance coverage and financial support.

• Maintain thorough clinical records through precise and detailed documentation.

• Coordinate interdisciplinary care to ensure timely access, continuity among providers, and optimal resource utilization.

• Apply care transition principles and manage smooth hand-offs to relevant providers and/or health plans.

• Assist the UM Manager and take part in both internal and external audits.

• Act as the primary liaison with contracted health plans for case management tasks.

• Safeguard the privacy and security of PHI in accordance with Medical Group/MSO policies and HIPAA regulations.

• Perform additional responsibilities and special projects as assigned.

⛳️ Requirements

• Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) is required.

• A minimum of two (2) years’ experience in utilization management, applying evidence-based clinical criteria and benefit plans is essential.

• At least three (3) years’ clinical experience, ideally in case management or a related field, is required.

• A Bachelor’s degree in nursing or a related health services discipline is necessary.

• Certified Case Manager (CCM) certification is preferred.

• Proficiency in Tagalog or Ilocano is preferred.

• Familiarity with Medicare, Medicaid, and other entitlement programs is required.

• Understanding of HIPAA regulations and PHI privacy and security is essential.

🏝️ Benefits

• Remote position.

• Equal Employment Opportunity and Affirmative Action employer.

• Reasonable accommodation available for applicants with disabilities.