Case Manager Assistant / LPN

MedWatch • FL

90d • $23 - $27

About The Position

The Case Manager Assistant assists the RN Case Manager in performing necessary functions using the case management process in order to meet the needs of the MedWatch, LLC customers and consumers. This includes, but is not limited to: authorization of services, review of treatment plans for medical necessity, standards of care, and ongoing communication with all members of the health care team. The Case Manager Assistant performs all functions under the direct management and supervision of the RN Case Manager. This is a Remote (work from home) position.

Requirements

• Licensed Practical Nurse or Medical Assistant/Nursing Assistant Certification (current active and unrestricted).
• 5 years of varied clinical experience preferred, or 3 years in a specialty field.
• Basic computer skills.

Nice To Haves

• Licensed Practical Nursing Education preferred.

Responsibilities

• Practice within the scope of licensure under the direct supervision of the RN Case Manager.
• Perform case management functions as directed by the Case Manager, excluding Initial Case Assessments and Formulation of the Initial Care Plan.
• Review all medical data to update a case management plan incorporating contact with providers, payers, patients, and primary caregivers.
• Contact payer offices to understand benefit constraints impacting the plan of action.
• Verify medical necessity of care or equipment ordered by contacting medical care providers and equipment vendors.
• Make care arrangements for quality patient care according to patient needs, physician orders, and available benefits.
• Provide cost-benefit analysis to payers for recommended alternative treatments when no benefits are available.
• Familiarize with community resources and funding sources to assist patients in receiving quality health care.
• Document case actions for each patient in the computer system under the direction of the Case Manager.
• Prepare timely reports to the payer detailing all case actions, results, and continuing case management plans.
• Maintain billing as appropriate in the computer system.
• Continue contact with providers and patients to ensure needs are met, especially for chronic conditions.
• Negotiate with providers to maximize medical benefits available to patients.
• Act upon awareness of non-medical issues affecting patient safety or welfare.
• Consult regularly with the Case Manager and keep them informed of any complaints or issues.
• Adhere to all company policies as stated in the employee handbook.
• Participate in the Quality Management Program by identifying opportunities for improvement.

Benefits

• Remote work opportunity.
• Salary range from $23 to $27 per hour.

What This Job Offers

• Education Level: No Education Listed
• Number of Employees: 101-250 employees