Detail for Selected Job:

Job Title: LVN Case Manager
Broad Job Category: Medical/Health
Specific Job Category: Nursing
Job Description: This position will be assigned to patients who require special coordination due to the complexity of their illness, psychosocial circumstances, or a pattern of frequent utilization of the acute hospital and other services as well as another other barriers that might hinder the member from achieving health goals or quality of health services. Minimum 2 years case management, utilization management and or discharge planning experience in an IPA, Medical Group, Hospital or Health Plan environment California LVN License with 3 years of experience in managed care and or acute care hospital setting, IPA, Medical Group or Health Plan environment Knowledge of Miliman, Interqual, Medicare, Medi-Cal, NCQA guidelines Home Health or Hospice experience preferred Responsibilities: •Initiate a case management screening assessment, reviewing claims history, encounter history, chronic conditions etc. . •Develop an initial intake & care plan based on screening and or referral to Case Management. •Schedule and conduct an initial assessment to include: medical history, medications, DME, support systems, barriers to compliant behaviors, educational needs, and significant impairments of ADL's, behavioral and or social barriers, cognitive barriers •Risk stratifies the member @ high, medium or low risk •Develops an evidence based plan of care that is member centric and based on risk and acuity. •Implement plan of care, document all patient encounters and contacts made on behalf of the patient in the case management system We are an equal employment opportunity employer.
Recruiter: Matt Owens
Phone: (714) 596-2902

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