Case Manager LPN/LVN (NY resident; a valid LPN or LVN license is required) Join to apply for the Case Manager LPN/LVN (NY resident; a valid LPN or LVN license is required) role at Liberty Dental Plan .
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What You'll Do: Inform enrollees of available covered dental benefits.
Help to resolve enrollee conflicts and barriers to dental care.
Educate enrollees on their rights and responsibilities.
Provide enrollees the information on accessing the LIBERTY vehicles for complaints, appeals or grievance process.
Ensure enrollee cases and events are documented correctly in the Health Solutions Plus (HSP) database.
Manage telephone calls and email inquiries not limited to, seeking dental services, dissatisfaction, and second opinions.
Provide education pertaining to the Liberty Care Coordination Program.
Provide research and response to various inquiries.
Compose comprehensive written responses to all applicable inquiries.
Review and edit, as applicable, all State Agency Provider Network Verification File (PNV) responses prior to submission to Liberty Quality Management.
Perform Liberty process for enrollees in need of hospital services for dental issues, and delegate such performances to CCM, upon the CCM’s ability to accomplish.
Ensure all newly ascertained State Medicaid dental providers are directed to Liberty Provider Relations to insure credentialing.
Provide continual Care Coordination communications pertaining to the update and interpretation of state contractual directives for State Medicaid enrollees to the CCM.
Perform dental case turnaround time in accordance with access standards regardless of the communication route (e.g., HSP inquiry, workflow, email, facsimile, phone call, etc.).
Able to work collaboratively within remote locations.
Ensure compliance to all regulatory guidelines.
Comply with all Liberty corporate and department guidelines, policies, and procedures.
Ensures treatment plans and guardianship documents are attached to applicable enrollee HSP file, including shelter orders for foster and Medical Foster Enrollees.
Review dental care plans every six (6) months or per State contract requirement and ensure dental care plans are attached to enrollee HSP file.
Participate in Multidisciplinary Care Team meetings for Liberty State Medicaid enrollees, as applicable.
Perform other duties as assigned or determined appropriate.
The CM may assist with other lines of business as directed and educated to perform.
The CM will work collaboratively with Liberty divisions and external partners such as dental offices, primary dental providers, care coordinators, home and community-based service representatives, transportation vendors, hospital representatives, primary care physicians or delegates, legal representatives, varying State Government Agencies, Foster/Medical Foster and Community-Based Service providers.
What You'll Bring: Current valid license as a Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) 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 Dental environment.
2 years' previous experience in a Case Management position required.
Specific Skills Care Coordination experience preferred.
Working knowledge of Microsoft Excel, Word and Outlook.
Capable of composing comprehensive written and verbal responses to inquiries.
Critical thinking skills to appropriately resolve inquiries, escalated cases and orchestrate holistic care.
Experience in conflict resolution and providing one-call resolution.
Bilingual English/Spanish, preferred. Able to pass a Spanish dental terminology exam.
Self-starter and a team player with strong organizational skills.
Must have a high degree of patience, excellent communication and interpersonal skills.
Ability to work independently or in a team.
Location Candidate must reside in New York.
What Liberty Offers Liberty offers competitive and attractive benefit packages for our employees. Our first-class benefits package supports employees and their dependents with:
Competitive pay structure and savings options to help you reach your financial goals.
Excellent 401(k) retirement benefits , including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice.
Affordable medical insurance , with low-cost premiums for employee-only coverage. Liberty subsidizes the cost for eligible dependents enrolled in the plan.
100% employer-paid dental coverage for employees and eligible dependents.
Vision insurance with low-cost premiums for employee-only coverage and dependents.
Company-paid basic life and AD&D insurance , equal to one times your base salary, with options to purchase additional supplemental coverage.
Flexible Spending Accounts for healthcare and dependent care expenses.
Voluntary benefit programs , including accident, critical illness, and hospital indemnity insurance.
Long-term disability coverage .
Expansive wellness programs , including company-wide wellness challenges and gym discounts.
Employee Assistance Program (EAP) to support mental health and well-being.
Generous vacation and sick leave policies, with the ability to roll over unused time.
10 paid company holidays .
Tuition reimbursement for eligible educational expenses.
Remote or hybrid work options available for various positions.
Compensation In the spirit of pay transparency, the base salary range for this position is $27.00 - $35.00 , not including fringe benefits or potential bonuses. Final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and consider internal equity of current team members when making final compensation decisions. Offers are typically not made at the top of the range to allow for future salary growth.
Liberty Dental Plan complies with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, transfers, work authorization, and employment eligibility verification requirements.
Sponsorship and Relocation Specifications Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled. No relocation assistance or sponsorship available at this time.