Case Manager Assistant, LPN

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

📋 Description

• Support the RN Case Manager with case management responsibilities under direct supervision and management.

• Authorize services and evaluate treatment plans for medical necessity and adherence to care standards.

• Maintain continuous communication with members of the healthcare team, including providers, payers, patients, and caregivers.

• Review medical information and update case management plans accordingly.

• Contact payer offices to comprehend benefit limitations impacting patient care strategies.

• Reach out to providers and equipment vendors to confirm medical necessity.

• Organize quality patient care based on individual patient needs, physician directives, and available benefits.

• Assess alternative treatment options and deliver cost-benefit analyses for extra-contractual services when suitable.

• Identify community resources and funding opportunities for patients.

• Document case actions and finalize case records in the computer system.

• Prepare prompt reports for payers outlining case actions, outcomes, and future plans.

• Manage billing within the computer system as necessary.

• Maintain contact throughout the continuum of care and oversee chronic-condition cases.

• Negotiate with providers to optimize available medical benefits.

• Make network referrals as deemed appropriate.

• Address non-medical issues related to patient safety or welfare and refer patients to suitable resources or authorities.

• Regularly consult with the Case Manager and report any complaints or issues outside the assistant's expertise.

• Comply with company policies and engage in the Quality Management Program.

⛳️ Requirements

• Current, active, and unrestricted Licensed Practical Nurse license or certification as a Medical Assistant/Nursing Assistant.

• License or certification must be valid in the applicant's current state of practice and residence within the United States or its territories.

• Preferred educational background in Licensed Practical Nursing.

• Basic computer proficiency required.

• Five years of diverse clinical experience preferred, or three years in a specialized field.

• Practice must align with the scope of licensure.

• Ability to work in a typical home office setting with extended periods of computer use.

• Adequate hand-eye coordination and manual dexterity to operate standard office, computer, and phone equipment.

• Must be eligible to work in the United States for any employer without sponsorship.

🏝️ Benefits

• Paid time off

• Medical insurance

• Dental insurance

• Vision insurance

• Short-term disability

• Long-term disability

• Life insurance

• AD&D insurance

• 401(k) with matching contributions

• Critical illness coverage

• Legal plan

• Identity theft protection

• Pet insurance

• Discount programs