Care Specialist, LPN

🕒 July 25

🌪️ Oklahoma – Remote

🌪️ Oklahoma – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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GlobalHealth, Inc.

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2003

🛡️ Insurance

🏥 Healthcare

⚕️ Healthcare Insurance

Insurance • Healthcare • Healthcare Insurance

GlobalHealth, Inc. is a health insurance company that offers Medicare Advantage (Part C) HMO plans, including Chronic Special Needs Plans (C-SNP) and Dual Special Needs Plans (D-SNP), primarily serving beneficiaries in Oklahoma. It provides Medicare and Medicaid-contracted benefit plans with prescription drug (Part D) coverage, supplemental benefits (dental, vision, hearing, OTC allowances), home support services, transportation, fitness benefits, and member/provider portals and tools for enrollment, claims, and care management. GlobalHealth focuses on serving retirees and dual-eligible or chronically ill populations through local agent support, provider networks, and compliance with Medicare quality standards.

📋 Description

• Conducts telephonic case management for complex, high-risk members • Coordinates with providers when applicable to ensure holistic, healthy, beneficial outcomes • Communicates with respect to family culture, ethnic origin, race, language, gender, age, religion, socioeconomic status, sexual orientation, mental and/or physical challenges • Provides patient advocacy, support, assessing and ensuring quality care, and providing crisis intervention • Coordinates services for members, including community resources and collaboration with care team members • Educate members and their caregivers on conditions and self-management techniques • Participate in elements of the SNP MOC, including completing HRA and working with the member to reach desired goals • Complete TOC activities to include post-discharge assessment, medication reconciliation/review, and ensuring member has access to follow up care.

🎯 Requirements

• Active Licensed Practical Nurse in the state of Oklahoma required • Active multi-state license is preferred • Previous experience in managed care/utilization management preferred • Knowledge of current nursing processes, techniques, and established standards • Strong attention to detail and good organization and time management skills • Must be able to communicate, both orally and in writing, clearly and effectively • Knowledge of Microsoft software programs including Word, Excel, and PowerPoint • Proven ability to work independently or as a member of a team.

🏖️ Benefits

• Health insurance • Affordable health insurance coverage • Personalized care services