LPN Case Manager

Job Duties

• Frequently exerting 10 to 20 pounds of force to move objects; occasionally exerting up to 100 pounds of force.
• Collaborates with hospital staff, as required, for authorization/certification processes.
• Explores strategies to reduce length of stay and resource consumption for case managed patient populations.
• Identifies appropriate patients for the various third-party payor pre-certification or pre-authorization process.
• Performs pre-admission, admission, and continued stay reviews as directed per content management system (CMS) or commercial payer guidelines and/or hospital policy.
• Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.
• Performs other related duties as required.

Knowledge, Skills and Abilities (KSAs)

• Working knowledge of admission criteria including, International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes and Medical Necessity guidelines.
• Computer skills and dexterity for data entry and retrieval of information.
• Effective verbal and written communication skills and ability to present information clearly and professionally.
• Proficient with Windows-style applications, various software packages specific to role and keyboard.