Job Description
Job Description
Job Summary:
We are seeking a dedicated and compassionate Licensed Vocational Nurse (LVN) Case Manager to join our dynamic healthcare team. The LVN Case Manager will be responsible for overseeing a diverse caseload, coordinating patient care, conducting medical necessity reviews, and ensuring regulatory compliance. The ideal candidate will possess excellent clinical skills, strong organizational abilities, and a passion for patient advocacy. This role involves both in-person and telehealth interactions to effectively manage treatment plans and patient relationships.
Duties/Responsibilities:
- Perform comprehensive assessments of patients' medical, psychosocial, and functional needs.
- Develop, implement, and revise individualized care plans, monitoring progress toward patient goals.
- Facilitate smooth transitions between different levels of care, including post-discharge visits and coordinate care between patients, ER, hospitals, and Urgent Cares.
- Provide ongoing support and case management in accordance with the case/treatment plan and Transfer of Care.
- Oversee the day-to-day administrative duties of the department.
- Perform audits to ensure quality assurance.
- Conduct clinical/medical necessity reviews and authorize services that meet medical criteria.
- Act as a liaison between patients, families, healthcare providers, and community resources.
- Maintain accurate and up-to-date patient records in accordance with regulatory and organizational standards.
- Keep current with knowledge and understanding of applicable accreditation and regulatory statutes related to healthcare, managed care, and case management practice.
- Performs other duties as assigned.
Education and Experience:
- Current and valid Licensed Vocational Nurse (LVN) license in the state of California required.
- Associate or Bachelor's degree in nursing, healthcare/business administration, or equivalent experience required.
- Minimum of 2 years of clinical nursing experience in a medical setting (e.g., office, hospital, SNF, medical clinic) required.
- Minimum of 1 year of experience in a managed care or healthcare environment related to Case Management.
- Current BLS certification required.
- Experience in managed care, palliative care, hospice, or neurology preferred.
- Experience with virtual care and telemedicine preferred.
- Knowledge and experience in working with homeless individuals and marginalized populations preferred.
- Experience in acute care and/or ICU/CCU settings preferred.
- Experience with Medicare and Medi-Cal environments preferred.
Required Skills/Abilities:
- Strong knowledge of medical terminology, healthcare systems, and case management principles.
- Excellent communication, interpersonal, and organizational skills.
- Proficiency in electronic health record (HER) systems and basic computer applications.
- Certification in Case Management (e.g., CCMC or ARN) preferred.
- Knowledge of Core Measures and basic statistics preferred.
- Bilingual in English and Spanish preferred.
Physical Requirements:
- This position will require occasional travel to healthcare facilities and community resources to build relationships.
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 10 pounds at times
Pay range$68,640—$83,200 USD