LPN Proactive Case Manager

POSITION SUMMARY:                                                                                                                                         
Performs all aspects of telephonic case management to improve the long-term wellness of members, becoming an advocate for our members through coordination of care.

ESSENTIAL DUTIES AND RESPONSIBILITIES:                                                                                           

·         Manages assigned caseload to meet both quantitative and qualitative objectives.

·         Conducts telephonic case management for complex, high-risk, and diversified members to include identification and assessment of needs, planning and coordination of care, and monitoring outcomes in accordance with GlobalHealth and the department’s policies and procedures.

·         Identifies and provides solutions to social barriers for members.

·         Coordinates with appropriate specialty as needed to ensure holistic, healthy, and beneficial outcomes for the member.

·         Remains aware of patient needs and changes in patient’s condition providing patient advocacy, assessing and ensuring quality care, and providing crisis intervention.

·         Communicates additions and changes to the Community Resource List to the appropriate party.

·         Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.

·         Performs other duties as assigned

EDUCATION AND EXPERIENCE:                                                                                                                     

·         Active Licensed Practical Nurse in the state of Oklahoma required.

·         Two years of experience in clinical nursing or a managed care position required.

KNOWLEDGE, SKILLS AND ABILITIES:                                                                                                         

·         Knowledge of current nursing processes, techniques and established standards, including disease management, medications and community resources

·         Strong attention to detail

·         Strong organization and time management skills, including ability to multi-task, learn new skills and reach set goals

·         Must be able to communicate, both orally and in writing, clearly and effectively

·         Knowledge of Microsoft Office programs including Word, Excel, and Outlook

·         Proven ability to work independently or as a member of a team

WORK ENVIRONMENT:                                                                                                                                      

Work is typically performed in an office or other equivalently good environment with rare presence of abnormal variations in temperature or exposure to outside conditions. Physical effort normally found in clerical work or the equivalent. Work is primarily sedentary; however, occasional handling of small objects (up to approx. 10 lbs.), and occasional walking or standing may be required

TRAVEL:                                                                                                                                                                 

May require limited travel for offsite meetings or training.

SUPERVISORY RESPONSIBILITY:                                                                                                                  

This position does not have any supervisory responsibilities.

OTHER DUTIES:                                                                                                                                                   

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.