GENERAL PURPOSE OF POSITION
We are seeking a dedicated LPN for an in-office position responsible for coordinating high-quality healthcare services across the full continuum of care. In this role, you will ensure the right services and resources are delivered at the right time—driving efficiency, improving outcomes, and maintaining cost-effective care for every patient.
HIGHLIGHTS:
Apply your clinical expertise in an office-based setting with no direct patient care, no weekends or holidays, and a stable schedule
ESSENTIAL RESPONSIBILITIES include the following. Other duties may be assigned.
- Familiarity with all plan benefits.
- Analyze clinical information provided by fax or phone, and determine treatment recommendations based on existing criteria guidelines.
- Determine if clinical information is adequate and appropriate for requested treatment plan.
- Complete reviews within designated URAC timetable.
- Perform care management activities as needed. Familiarity with and access to all clinical criteria guidelines before determining need for secondary review.
- Monitor changes in level of care (LOC) and appropriateness of changes.
- Participate in discharge planning.
- Review for medical necessity of durable medical equipment.
- Participate in negotiations as required.
- Prioritize phones, pre-certifications and follow through for pre-certifications.
- Acknowledge when a manager’s intervention is necessary.
- Perform clerical activities as needed (letters, faxing, etc.)
- Assist and identify areas for improvement and problem solving (QIP).
- Complete appeal determinations received from Physician review.
- Understand, suggest revisions and apply policies and procedures correctly.
- Serve as backup to the Disability Specialist
May be called upon to perform other job tasks and/or project-oriented work within skill level. In addition, may be cross-trained on select tasks for back-up purposes.
Chesterfield offers a VERY competitive benefits package designed to support you from the start of your career with us.
- Benefits begin the first of the month following a 30-day waiting period
- Start earning PTO after the first of the month following your 30-day waiting period
- Annual bonus opportunities
- Yearly raises to reward your growth and performance
Join a team that values your contributions and invests in your long-term success.
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty listed above satisfactorily. Additionally, the requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
REQUIRED
- 1-2 years minimum experience in a clinical environment.
- Proven ability to communicate effectively with clients, claimants, providers, professionals and other team members as required
- Ability to read and interpret documents such as operating procedures, manuals and medical records
· Ability to write routine reports and correspondence.
· Ability to perform basic mathematical calculations.
· Ability to work independently and problem solve.
· Must be organized and have the ability to multi-task.
· Basic computer skills including data entry and working knowledge of Windows, Excel and Word.
CERTIFICATES, LICENSES, REGISTRATIONS:
Required: Active LPN license required.
Job Type: Full-time
Pay: From $50,000.00 per year
Benefits:
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Vision insurance
License/Certification:
Ability to Commute:
- Akron, OH 44685 (Required)
Work Location: In person
