Case Manager, LVN or LPN

About the role

The Case Manager is responsible for providing confidential, unbiased assistance to eligible Liberty Dental Plan enrollees of State Medicaid programs in need of dental services who also have a co-morbidity of special health care needs. Responsibilities also include, and are not limited to, assisting the Coordinators Care Management (CCMs) to perform their professional functions.

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