Case Manager, LPN

Role Overview

• Provide both clinical and operational support through data collection, care coordination activities, provider and vendor communication, timely report distribution, and day‑to‑day assistance to team experts and leadership.
• Support member outreach, referrals, appointment scheduling, and accurate documentation to ensure efficient, compliant care coordination.
• Initiate referrals and support care coordination workflows by gathering clinical, functional, and social information needed for RN led case assessment and service planning, following established case management procedures.
• Perform structured case management support activities (e.g., follow up calls, resource coordination, appointment scheduling, and preparation of case summaries) using predefined tools and templates, escalating any findings that require RN/Medical Director interpretation.
• Communicate with members, providers, caregivers, and internal teams regarding required documentation, service logistics, resource connections, and case status, using approved scripts and escalation pathways.
• Participate in quality improvement, compliance activities, and competency requirements tied to case management program standards.

Requirements

• License Licensed Practical Nurse (LPN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.
• 1-2 years
• Clinical experience required.
• Knowledge of community resources, benefits, and service authorization processes.
• Familiarity with care management frameworks and regulatory requirements.
• High attention to detail with the ability to document accurately and meet regulatory standards (NCQA, URAC, CMS).

Benefits

• Various immunizations and/or associated medical tests may be required for this position.
• Digital literacy assessment required.