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Direct message the job poster from LanceSoft Inc.,
Duration: 5+ months with possible extension
Est. Pay Range: $29.00/hr. to $32.00/hr.
Schedule: M-F 8-5
Position Summary
Complete health screening questionnaires, assessments which may be market specific.
Support reduction of population of unable to reach members by telephone and in -person visits.
Ensure member has filled/received their medication(s) and has an understanding on how to take their ordered medications.
Manage caseload of members with current stratification of monitoring, low and medium or those with high social determinants of care needs- frequency /contract guidelines
Provides clinical assistance to determine appropriate services and supports due to member’s health needs (including but not limited to: Prior Authorizations, Coordination with PCP and Specialty providers, Condition Management information and education, Medication management, Community Resources and supports)
Evaluation of health and social indicators
Identifies and engages barriers to achieving optimal member health.
Uses discretion to apply strategies to reduce member risk.
Presents cases at case conferences for multidisciplinary focus to benefit overall member management.
Facilitates overall care coordination with the care team to ensure member achieves optimal wellness within the confines of the member’s condition(s) and abilities to self-manage.
Coordinates resources, assists with securing DME, and helps to ensure timely physician follow-up.
Understands Payer/Plan benefits, policies, procedures, and can articulate them effectively to providers, members, and other key personnel.
Updates the Care Plan for any change in condition or behavioral health status.
Provide support to members in transitions of car
Duties:
Responsible for interacting with low stratification members via phone calls, coordinating care, completing, reviewing, and updating assessments and care plans that address problems, goals, and interventions.
Based on assessments and claims data creates a care plan for members to follow 70%
Participate as a member of the Care Team during Interdisciplinary Team meetings to discuss the member’s health care needs, barriers to care and explore better outcomes for the member 20%
Identify and link members with health plan benefits and community resources 5%
Perform administrative work to maintain skills needed for job duties 5% 5%
Experience:
Required: 2 years LPN Nursing exp, preferred 3 + year’s experience.
Regular and reliable attendance
Familiar with community resources & services
Strong organizational skills
Works independently.
Maintains professional relationships with the members we serve as well as colleagues.
Communicates effectively and professionally verbally and in writing.
Proficient with computer systems
Knowledgeable in Microsoft Office Software
Has a dedicated homework space
Education:
HS or equivalent, must be licensed LPN.
Employee Benefits:
At LanceSoft, full time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:
Four options of medical Insurance
Dental and Vision Insurance
401k Contributions
Critical Illness Insurance
Voluntary Permanent Life Insurance
Other Employee Perks
Seniority level Seniority level Entry level
Employment type Employment type Full-time
Industries IT Services and IT Consulting
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