Case Manager Assistant, LPN

🕒 August 8

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MedWatch, LLC

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1988

💼 Consulting

📦 Logistics

🛡️ Insurance

Consulting • Logistics • Insurance

MedWatch, LLC is a healthcare services company that provides utilization management, case management, disease management, member advocacy and concierge care coordination to payers, TPAs, and self‑insured employers. For over 35 years it has delivered clinically driven care management, precertification and claims solutions, direct contracting and ancillary services backed by URAC accreditations and proprietary in‑house technology to improve clinical outcomes and reduce plan and member costs.

📋 Description

• Assist the RN Case Manager with case management functions under direct management and supervision • Authorize services and review treatment plans for medical necessity and standards of care • Maintain ongoing communication with healthcare team members, providers, payers, patients, and caregivers • Review medical data and update case management plans • Contact payer offices to understand benefit constraints affecting patient care plans • Contact providers and equipment vendors to verify medical necessity • Arrange quality patient care according to patient needs, physician orders, and available benefits • Evaluate alternative treatment possibilities and provide cost-benefit analyses for extra-contractual services when appropriate • Identify community resources and funding sources for patients • Document case actions and complete case records in the computer system • Prepare timely reports for payers detailing case actions, results, and ongoing plans • Maintain billing in the computer system as appropriate • Maintain contact across the continuum of care and monitor chronic-condition cases • Negotiate with providers to maximize available medical benefits • Make network referrals as appropriate • Address non-medical issues involving patient safety or welfare and refer patients to appropriate resources or authorities • Consult regularly with the Case Manager and report complaints or issues beyond the assistant's competence • Adhere to company policies and participate in the Quality Management Program

🎯 Requirements

• Current, active, and unrestricted Licensed Practical Nurse license or Medical Assistant/Nursing Assistant certification • License or certification must be valid in the applicant's current state of practice and residence within the United States or its territories • Licensed Practical Nursing education preferred • Basic computer skills • Five years of varied clinical experience preferred, or three years in a specialty field • Practice within the scope of licensure • Ability to work in a typical home office environment with prolonged computer sitting • Hand-eye coordination and manual dexterity sufficient to operate standard office, computer, and phone equipment • Ability to work in the United States for any employer without sponsorship

🏖️ Benefits

• Paid time off • Medical insurance • Dental insurance • Vision insurance • Short-term disability • Long-term disability • Life insurance • AD&D insurance • 401(k) with match • Critical illness coverage • Legal plan • Identity theft coverage • Pet insurance • Discount programs