A direct hire opportunity is available for a Case Manager / LPN Care Coordinator in Miami, FL. This role is ideal for an experienced Licensed Practical Nurse who wants to use clinical knowledge in a non-bedside, insurance-focused care coordination setting.
The Case Manager will support insured student members by helping them navigate healthcare services, insurance benefits, claims, referrals, authorizations, and provider access.
Responsibilities
- Conduct outreach calls to insured members to complete basic health assessments, review care needs, and follow up on active cases.
- Coordinate healthcare services for students, including locating appropriate in-network providers, facilities, specialists, DME, and home health resources when needed.
- Review medical records, utilization history, claims activity, benefits, referrals, and prior authorizations to support accurate case management.
- Assist with claims follow-up, eligibility verification, benefit questions, provider network research, and insurance navigation.
- Maintain accurate case notes while ensuring HIPAA compliance and confidentiality of all medical information.
Qualifications
3+ years of experience in health insurance, HMO setting.
Strong medical background with knowledge of medical terminology, clinical workflows, and basic chronic disease management.
Familiarity with commercial HMO/managed care, including claims, referrals, prior authorizations, and benefits.
...~409 licensed beds ~7 on / 7 off schedule ~ ICU - Closed ~ EPIC EMR Desired Candidate: Career-minded licensed Hospitalist Board certified or eligible Commitment to providing high-quality, compassionate care to patients Team-oriented with ability...
...true patient connection?\n \n UPMC Home Health is hiring Casual Registered Nurses (RNs) across the Williamsport and Surrounding areas\n \n This role offers the opportunity to provide one-on-one care in patients homes, build meaningful relationships, and...
Inivilize n smll grop instrction for stents ge 9-18+. Hors re sesonl/vrible, n epen on stent emn n yor vilbility. To be eligible for remote employment, yo mst resie in OR, W, or NC. bot North vene Ection, LLC Fone in 213, North vene is Portln-bse ttoring compny...
...Join Bertram Dental Lab as a Dental Lab Technician Craft Precision Removable Partial Dentures in a Dynamic Team Environment! At Bertram Dental Lab, we are passionate about advancing dental technology to improve lives. Located in Menasha, WI, our dedicated team collaborates...
Fidelity will not provide immigration sponsorship for this position.Job Description:The RoleIn this role, you will be working with a team of technologists passionate about Quality Assurance and Engineering. As a technical associate of this team, you will partner with development...