Christian Care Ministry · 3 months ago
Inpatient LPN Care Manager
Melbourne, FL | Orlando, FL | Hybrid
Full-time
Hybrid
Entry, Mid Level
$25/hr - $34.13/hr
2+ years expChristian Care Ministry (CCM) is a healthcare sharing ministry for Christians. The Inpatient LPN Care Manager supports Medi-Share members needing inpatient and/or outpatient medical services by explaining the provisions of the member-voted guidelines and connecting them to high quality care for optimal outcomes.
Financial ServicesHealth CareNon Profit
Responsibilities
Works with leadership, clinical staff, key internal departments, and external customers to ensure optimum clinical outcomes for members
Reviews and interprets members’ medical records and compares them against proprietary and evidenced-based criteria to determine eligibility for bill sharing and advocacy for additional programs and interventions; determines if the medical record documentation supports the eligibility of requested and/or billed services
Abstracts review-related data/information accurately and timely in appropriate review systems by the appropriate means. Provides accurate and timely submission of all administrative and review-related documents to appropriate parties
Performs ongoing reassessment of review process to offer opportunities for improvement and/or change
Reviews requests for genetic testing to determine eligibility for sharing and implements appropriate reimbursement strategies
Advocates for members using the Medi-Share program to meet their health care needs
Performs case reviews, checks medical records, speaks with patients and care providers regarding treatment and collaborates with plan of care
Reviews pre-notification of services and clinical information for care management intervention and medical appropriateness
Performs clinical reviews paying close attention to the appropriateness of healthcare expenditures to include length of facility stays and outpatient therapy services
Performs concurrent review and discharge planning for inpatients
Provides for continuity of care
Researches and assists the negotiations for LOA/SCAs for inpatients transitioning to different level of care
Assures appropriate levels of care are received by patients
Provides appropriate consultation and referral to intra- and interdepartmental resources to ensure members receive optimum services offered by organization
Manages assigned clinical caseload meeting SLAs
Performs administrative and clinical processes to ensure team and departmental goals are met
Delivers accurate and comprehensible verbal and written communication to external customers while complying with organizational HIPAA requirements
Maintains accurate and timely records of all communications and interventions
Attends all required department and organization meetings
Contributes to the exercise and expression of Christian Care Ministry’s Christian beliefs
All other duties as assigned
Qualification
Required
Current unrestricted compact LPN/LVN license with sound knowledge of anatomy and physiology, medical terminology, and disease processes required
Graduate from an accredited Diploma, Associates Degree, or Bachelor's Degree Program required
2+ years of clinical experience and/or care coordination in an acute or med-surgical environment required
Transitional care/discharge planning required
1+ years working with EMRs and medical record/abstraction of data required
Must be proficient in Microsoft Office Suite, internet/web navigation and research required
Expert knowledge of Medi-Share program guidelines and processes
Strong organizational, prioritization, and process skills
Advanced Excel skills; intermediate Microsoft office skills (Outlook, Teams, Word)
Advanced knowledge of Salesforce, CSI/Eldorado use and documentation
Excellent computer skills – ability to access, research and use multiple software programs simultaneously and keyboard skills of at least 35 words per minute
Excellent research skills to using IT systems, internet, and phone
Accurate data collection, documentation, and analysis - provides effective and efficient collection and distribution of research data without the need for supervision; able to correlate research findings with solutions
Excellent ability to communicate effectively in written, oral, telephonic, and digital formats that build collaboration and facilitate positive outcomes
Ability to work independently and with a team regularly; able to perform assigned special projects with minimal assistance
Ability to comply with HIPAA, PHI, and all call compliance rules and regulations
Excellent ability to provide all content within a Biblical framework
Collaborates – builds partnerships and works collaboratively with internal departments, external healthcare providers, and members to meet objectives
Optimizes Work Processes – knows the most effective and efficient processes to get results with a focus on continuous improvement
Communicates Effectively – able to clearly and positively communicate needs and engage others to achieve objectives
Action Oriented – enjoys the challenge of effecting savings and presents an attitude of willingness, enthusiasm, and urgency to meeting objectives
Initiative – identifies what needs to be done with a willingness to take action
Drives Results – consistently achieves and/or looks for opportunities to obtain and report results
Preferred
Healthcare-related degree preferred
Benefits
100% paid Medical for employees/99% for family
Generous employer Health Savings Account (HSA) contributions
Employer-paid Life Insurance (3x salary) and Long-term Disability Insurance
6 weeks of paid parental leave (for both mom and dad)
Dental - two plans to choose from
Vision
Short-term Disability
Accident, Critical Illness, Hospital Indemnity
401(k) – up to 4% match on ROTH or Traditional contributions
Generous paid-time off and 11 paid holidays
Wellness plan including Financial, Occupational, Mental/Spiritual, and Physical health incentives up to $50/mo
Employee Assistance Program including no cost, in-person mental health visits and employee discounts
Monetary Anniversary Awards Program
Monetary Birthday Awards
Company
Christian Care Ministry
Christian Care Ministry (CCM) is a non-profit that administers Medi-Share, a healthcare sharing program where Christians come together to share each other’s medical bills.
501-1000 employees
H1B Sponsorship
Christian Care Ministry has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2021 (1)
Funding
Current Stage
Late StageLeadership Team
Ian Day
Chief Medical Officer
Recent News
Business Journals
2022-05-27
Company data provided by crunchbase