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Required Education: High school Diploma or GED Job Industry: Healthcare - Health Services Job Description: Schedule: Full Time / Hours between 8am & 5pm.
Pay: $33 - $46 - Depending on Experience Job Type: Temporary Assignment Job Summary: The LVN case manager will be responsible for identifying (California Children Services) CCS cases, handling transfers, and retro reviews.
Works as part of an interdisciplinary care team coordinating social work and mental health counseling, psycho-social support services, in-home support, legal services, skilled nursing, home health, etc.
Effectively collaborates with the hospitalist, the hospital nursing personnel, members of the interdisciplinary care team, and the physician in the clinic management.
Key Responsibilities: Responsible for daily concurrent reviews, retro reviews, discharge planning, pre-certification/prior authorization request review, and ensures patients meet appropriate level of care based on acceptable evidence-based Clinical Criteria(s).
Participate in the development of all program material, Policies and Procedures related to the nurse case management program; may also develop program informational and educational materials and various forms.
Identifies and enrolls patients into a case management program providing intensive service.
Works in an office environment, climate controlled through air conditioning.
Required Skills and Abilities: Able to sit, stand, lift (up to 15 lbs), bend, walk, as required for carrying out duties of positions.
Excellent customer service skills and ability to resolve difficult customer service issues and/or escalate to supervisor as needed.
Knowledge of the Case Management Process, Chronic Care Model, and Patient-Centered Medical Home Model (PCMH).
Knowledge of regulatory requirements, health plan contracts, governmental benefits, and community resources.
Required Qualifications: Graduation from an accredited LVN nursing program.
Current valid License as a Licensed Vocational Nurse.
Experience: Three years of experience in public health nursing, acute care, case management, and/or in-home health care required; minimum of 2 years of managed care experience in case management with a focus in inpatient and/or outpatient ambulatory care preferred.
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