Case Manager, LVN/LPN

🔥 0 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $29 - $34 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Liberty Dental Plan

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2002

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Liberty Dental Plan is a U. S. -based dental insurance provider offering Medicaid (including Medi-Cal), Medicare Advantage, commercial, individual & family, and group dental plans across multiple states. The company operates member-facing services (find-a-dentist, member portal, mobile app, claims and eligibility tools) and provider-facing services (provider portal, network enrollment, claims submission, clinical guidelines, and value-based programs). Liberty Dental Plan focuses on dental benefits administration, provider network management, compliance and credentialing, and serving members, providers, and brokers.

📋 Description

• Provide confidential, unbiased assistance to eligible Liberty Dental Plan State Medicaid enrollees with dental service needs and special health care comorbidities • Assist Care Coordinators of Care Management with professional functions • Inform enrollees about covered dental benefits and their rights and responsibilities • Resolve enrollee conflicts and barriers to dental care • Secure enrollee dental services • Explain complaint, appeal, and grievance processes and access to Liberty vehicles • Document cases and events in the Health Solutions Plus database • Manage telephone calls and email inquiries, including service requests, dissatisfaction, and second opinions • Provide education 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 to Quality Management • Process enrollee needs for hospital dental services and delegate 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 routes • Ensure compliance with regulatory, corporate, and department guidelines • Attach treatment plans, guardianship documents, and shelter orders to applicable enrollee files • Review dental care plans every six months or per state contract requirements and attach them to enrollee files • Participate in multidisciplinary care team meetings • Collaborate with Liberty departments and external entities including dental offices, providers, health plans, agencies, vendors, hospitals, physicians, legal representatives, and state agencies • Perform other assigned duties and assist other lines of business as directed

🎯 Requirements

• 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; dental experience preferred • 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 and escalated cases and orchestrate holistic care • Experience in conflict resolution and one-call resolution • Bilingual English/Spanish preferred • Ability to pass a Spanish dental terminology exam • Self-starter and team player with strong organizational skills • High degree of patience and excellent communication and interpersonal skills • Excellent customer service skills • Ability to work independently or in a team • Must be able to work in the United States • No sponsorship or relocation assistance available

🏖️ Benefits

• 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; Liberty subsidizes eligible dependents' coverage • 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 supplemental coverage options • Flexible Spending Accounts for healthcare and dependent care expenses • Voluntary accident, critical illness, and hospital indemnity insurance • Long-term disability coverage • Wellness programs, including wellness challenges, BurnAlong memberships, and gym discounts • Employee Assistance Program supporting mental health and well-being • Generous vacation and sick leave policies, including unused-time rollover • 10 paid company holidays • Tuition reimbursement for eligible educational expenses • Remote or hybrid work options available for various positions