[Remote] Case Manager, LVN | California license required

Note: The job is a remote job and is open to candidates in USA. Liberty Dental Plan is seeking a Case Manager who will provide confidential assistance to enrollees of State Medicaid programs in need of dental services. The role involves educating enrollees on their rights, resolving conflicts, and ensuring proper documentation and compliance with regulatory guidelines. Responsibilities • Inform enrollees of available covered dental benefits • Help to resolve enrollee conflicts and barriers to dental care • Assist in securing enrollee dental services • 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. This is inclusive of 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 meeting for Liberty State Medicaid enrollees, as applicable • Perform other duties as assigned or determined appropriate Skills • 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 • Applicants must reside in California and possess a current, valid LVN license • Care Coordination experience preferred • Bilingual English/Spanish, preferred Benefits • 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 through Financial Engines. • 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, BurnAlong memberships, 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. Company Overview • LIBERTY Dental Plan provides dental plans and insurance services. It was founded in 2001, and is headquartered in Irvine, California, USA, with a workforce of 1001-5000 employees. Its website is https://www.libertydentalplan.com. Apply tot his job Apply To this Job