Case Manager, LVN/LPN

🕒 il y a 11 jours

🗽 New York – Distant

🗽 New York – Remote

💵 $29 - $34 / heure

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

👻 Score fantôme 10%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Liberty Dental Plan

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 2002

🏥 Santé

💼 Conseil

📦 Logistique

Healthcare • Consulting • Logistics

Liberty Dental Plan est un fournisseur d'assurances dentaires basé aux États-Unis proposant des plans dentaires Medicaid (y compris Medi-Cal), Medicare Advantage, commerciaux, individuels et familiaux, ainsi que des plans de groupe dans plusieurs États. L'entreprise propose des services orientés vers les membres (trouver un dentiste, portail membre, application mobile, outils de réclamation et d'éligibilité) et des services orientés vers les prestataires (portail prestataire, inscription au réseau, soumission de réclamations, lignes directrices cliniques et programmes basés sur la valeur). Liberty Dental Plan se concentre sur l'administration des prestations dentaires, la gestion du réseau de prestataires, la conformité et l'accréditation, ainsi que sur le service aux membres, prestataires et courtiers.

Description

• Provide confidential, unbiased assistance to eligible Liberty Dental Plan State Medicaid enrollees with dental-service needs and special health care co-morbidities • Assist Care Coordinators in performing professional functions • Inform enrollees about covered dental benefits, rights, responsibilities, complaints, appeals and grievance processes • Resolve conflicts and barriers to dental care and help secure dental services • Document cases and events correctly in the Health Solutions Plus database • Manage telephone calls and email inquiries, including dental-service requests, dissatisfaction and second opinions • Educate enrollees about the Liberty Care Coordination Program • Research and respond to inquiries and compose comprehensive written responses • Review and edit State Agency Provider Network Verification File responses before submission • Process cases involving enrollees needing hospital services for dental issues and delegate tasks to Care Coordinators when appropriate • Direct newly ascertained State Medicaid dental providers to Provider Relations for credentialing • Communicate updates and interpretations of state contractual directives to Care Coordinators • Complete dental case turnaround within access standards across all communication channels • Ensure regulatory and corporate policy compliance • Attach treatment plans, guardianship documents and shelter orders to applicable enrollee files • Review dental care plans every six months or as required by state contracts • Participate in multidisciplinary care team meetings • Collaborate with Liberty divisions and external entities including dental offices, providers, health plans, agencies, vendors, hospitals, physicians and legal representatives • Perform other assigned duties and assist other lines of business as directed

🎯 Exigences

• Current valid LVN or LPN license 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 a Dental environment • 2 years' previous experience in a Case Management position required • Care Coordination experience preferred • Working knowledge of Microsoft Excel, Word and Outlook • Ability to compose comprehensive written and verbal responses to inquiries • Critical thinking skills to resolve inquiries, escalated cases and orchestrate holistic care • Experience in conflict resolution and providing one-call resolution • Bilingual English/Spanish preferred • Ability to pass a Spanish dental terminology exam • Strong organizational skills, patience, communication, interpersonal and customer service skills • Ability to work independently or in a team • Must work within the United States; employees cannot work outside the United States • No relocation assistance or sponsorship available

🏖️ Avantages

• Competitive pay structure and savings options • 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; subsidized eligible dependents • 100% employer-paid dental coverage for employees and eligible dependents • Vision insurance • Company-paid basic life and AD&D insurance equal to one times base salary, with options to purchase supplemental coverage • Flexible Spending Accounts for healthcare and dependent care expenses • Voluntary 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) • Generous vacation and sick leave policies, with unused leave rollover • 10 paid company holidays • Tuition reimbursement for eligible educational expenses • Remote or hybrid work options available for various positions