Lvn Case Manager Jobs

About The Position

Requirements

• Current valid license as a Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) in accordance with State of Residency.
• 4 years' experience as an LVN or LPN in public health, acute care, case management and/or in-home health care, preferably within Dental environment.
• 2 years' previous experience in a Case Management position required.
• Working knowledge of Microsoft Excel, Word and Outlook.
• Capable of composing comprehensive written and verbal responses to inquiries.
• Critical thinking skills to appropriately resolve inquiries, escalated cases and orchestrate holistic care.
• Experience in conflict resolution and providing one-call resolution.
• Self-starter and a team player with strong organizational skills.
• Must have a high degree of patience, excellent communication and interpersonal skills.
• Excellent customer service skills.
• Ability to work independently or in a team.

Nice To Haves

• Care Coordination experience preferred.
• Bilingual English/Spanish, preferred.
• Able to pass a Spanish dental terminology exam.

Responsibilities

• Inform enrollees of available covered dental benefits.
• Help to resolve enrollee conflicts and barriers to dental care.
• Assist in securing enrollee dental services.
• Educate enrollees on their rights and responsibilities.
• Provide enrollees the information on accessing the Liberty vehicles for complaints, appeals or grievance process.
• Ensure enrollee cases and events are documented correctly in the Health Solutions Plus (HSP) database.
• Manage telephone calls and email inquiries not limited to, seeking dental services, dissatisfaction, and second opinions.
• Provide education pertaining to the Liberty Care Coordination Program.
• Provide research and response to various inquiries.
• Compose comprehensive written responses to all applicable inquiries.
• Review and edit, as applicable, all State Agency Provider Network Verification File (PNV) responses prior to submission to Liberty Quality Management.
• Perform Liberty process for enrollees in need of hospital services for dental issues, and delegate such performances to CCM, upon the CCM’s ability to accomplish.
• Ensure all newly ascertained State Medicaid dental providers are directed to Liberty Provider Relations to insure credentialing.
• Provide continual Care Coordination communications pertaining to the update and interpretation of state contractual directives for State Medicaid enrollees to the CCM.
• Perform dental case turnaround time in accordance with access standards regardless of the communication route (e.g., HSP inquiry, workflow, email, facsimile, phone call, etc.).
• Able to work collaboratively within remote locations.
• Ensure compliance to all regulatory guidelines.
• Comply with all Liberty corporate and department guidelines, policies, and procedures.
• Ensures treatment plans and guardianship documents are attached to applicable enrollee HSP file. This is inclusive of shelter orders for foster and Medical Foster Enrollees.
• Review dental care plans every six (6) months or per State contract requirement and ensure dental care plans are attached to enrollee HSP file.
• Participate in Multidisciplinary Care Team meeting for Liberty State Medicaid enrollees, as applicable.
• Perform other duties as assigned or determined appropriate.
• The CM is not limited in providing customer care services when the need arises and may assist with other lines of business as directed and educated to perform.
• The CM will work collaboratively with multi-divisions of Liberty such as and not limited to Member Services, Claims, Grievances, Staff Dentists, Supervisors, Managers and Leadership.
• The CM will work collaboratively and interface with entities outside of Liberty such as Dental Offices, Primary Dental Providers and their representatives, health plan Care Coordinators, home and community-based service representatives, transportation vendors, hospital representatives, Primary Care Physicians or their delegates, legal representatives, varying State Government Agencies, Foster, Medical Foster and Community-Based Service providers.

Benefits

• Competitive pay structure and savings options to help you reach your financial goals.
• Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines.
• Affordable medical insurance, with low-cost premiums for employee-only coverage. Liberty subsidizes the cost for eligible dependents enrolled in the plan.
• 100% employer-paid dental coverage for employees and eligible dependents.
• Vision insurance with low-cost premiums for employee-only coverage and dependents.
• Company-paid basic life and AD&D insurance, equal to one times your base salary, with options to purchase additional supplemental coverage.
• Flexible Spending Accounts for healthcare and dependent care expenses.
• Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance.
• Long-term disability coverage.
• Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts.
• Employee Assistance Program (EAP) to support mental health and well-being.
• Generous vacation and sick leave policies, with the ability to roll over unused time.
• 10 paid company holidays.
• Tuition reimbursement for eligible educational expenses.
• Remote or hybrid work options available for various positions.