LVN Case Manager, Out of Area - Remote
About the position The LVN Case Manager position at UnitedHealth Group involves coordinating patient transitions to contracted facilities or the next level of care, ensuring compliance with health plan benefits and established contracts. This role requires effective communication with healthcare professionals and patients, as well as diligent documentation and management of patient care processes. The position offers the flexibility to work remotely for California residents with a valid LVN license.
Responsibilities
- Exhibit superior customer service skills in all interactions with internal and external customers.
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- Coordinate emergency department repatriations, safe transfers, and discharge instructions as directed by hospitalists.
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- Delegate discharge provisions including follow-up appointments and home health services to care coordinators.
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- Obtain additional clinical information to prevent delays in patient discharge or transfer.
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- Complete documentation for post stabilization requests and level of care decisions accurately and consistently.
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- Approve medically appropriate referrals within required regulatory timeframes.
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- Maintain effective communication with physicians, hospitals, and patients regarding care management decisions.
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- Communicate authorization or denial of services to relevant parties, including patients and physicians.
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- Prepare and send appeal packets for expedited appeal notifications within outlined timeframes.
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- Write Detailed Notice of Discharge (DND) and Detailed Explanation of Non-Coverage (DENC) for appeal packets.
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- Track team caseloads and complete staffing schedules, escalating issues to management as needed.
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- Identify opportunities for process improvement and participate in weekend and holiday coverage as needed.
Requirements
- Graduation from an accredited Licensed Vocational Nurse program.
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- Current, unrestricted California LVN License.
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- 1+ years of experience working as an LVN/LPN.
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- 1+ years of case management, utilization review, or discharge planning experience.
Nice-to-haves
- 3+ years of clinical experience working as an LVN/LPN.
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- Experience in an HMO or Managed Care setting.
Benefits
- 401(k) matching
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- Comprehensive benefits package
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- Incentive and recognition programs
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- Equity stock purchase
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