Care Manager-LPN

Company Overview: Pediatric Associates has been caring for infants, children and adolescents since 1955. Pediatric Associates opened its first office in Hollywood, FL. Since then, our physicians have cared for four generations of families with our first patients now bringing their children, grandchildren and great-grandchildren to our practice. With Coastal Kids in California, ABCD and MDMG in Texas, Arbor in Arizona, Tri-County in Pennsylvania, Mexico operations, and our operations based in New York and New Jersey, and Florida Pediatric Associates Family of Companies is proud to have expanded as much as we have and hope to grow even more in the future. We invite you to follow our path as we are the largest pediatric organization in the United States. This new growth brings great opportunities for candidates looking to join our fun and dynamic family of over 2,500 employees. Search our jobs today and see why Pediatric Associates is one of the best Pediatric practices in the United States. Job Opportunities: We offer excellent job opportunities for administrative, business and medical professionals. Our jobs include: front office receptionists, clinical staff, lab and x-ray technicians, billing and collections, operations managers, business professionals and healthcare providers. We also have opportunities for LPNs and RNs to provide triage and care via telemedicine.

Remote Opportunity Schedule: Monday - Friday 8am - 5pm EST Spanish Speaking Required PRIMARY FUNCTION The Care Manager, LPN assists in the care coordination for identified medically fragile and complex pediatric patient population. Functions as a liaison between the patient and the care team. Interacts with Primary Care Physician (PCP), front office, outside specialists, health plans, and patients/caregivers. Provides guidance and direction to Chronic Care Coordinators and may provide education to patients.

Conducts outbound calls to complete assessments of targeted medically complex pediatric patients. Collaborates with family and patient health care team to identify patient needs. Reviews current plans of care and makes recommendations per current state guidelines for medical necessity. Collaborates with the Medical Director to ensure appropriate service delivery including review of findings, criteria not met, determination of appropriate level of care, delay in services, alternative solutions, etc. Communicates treatment changes to the PCP, family, healthcare team, and others involved in patient care. Assists with coordinating and may participate in multidisciplinary rounds, peer to peer reviews, and individual case reviews for established patients. Participates in quality review processes to ensure active reviews are completed. Completes documentation in the care management platform and electronic health record. Responds to incoming and outgoing correspondence and requirements of plans of care and recertification. Reviews incoming referrals, plans of care, and consult notes. May escalate to the medical director for follow up. Functions as a resource on state requirements for home health guidelines. Participates in ongoing development, implementation, and evaluation of program and process effectiveness. Formulates recommendations for process modifications. Identifies opportunities and recommends methods to improve service, processes, and financial performance. Participates in internal initiatives. Participates in gathering information and data for CMS reporting. Functions as expert resource for staff. Provides guidance and direction to Chronic Care Coordinators and may provide education to patients. Provides courteous and prompt service to all internal and external customers.