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Care Coordinator-LVN
2 months ago
The Case Manager-LVN is a critical role that requires a unique blend of clinical expertise, communication skills, and business acumen. As a key member of our team, you will be responsible for managing patient care across the healthcare continuum, ensuring seamless transitions and optimal outcomes.
Key Responsibilities:- Conduct thorough assessments of patient needs and develop personalized care plans to address complex medical, socio-economic, and mental health challenges.
- Collaborate with healthcare providers, payers, and community resources to ensure timely and effective care coordination.
- Utilize evidence-based guidelines and clinical decision support tools to inform care decisions and optimize resource utilization.
- Provide education and support to patients and families, empowering them to navigate the healthcare system and make informed decisions about their care.
- Participate in on-call rotations and provide decision support on managed care issues, ensuring 24/7 coverage and exceptional patient care.
- Bachelor's Degree in a related field (preferred) or Graduate of a school of Licensed Vocational Nursing (LVN) with a minimum of 5 years of experience in managed care.
- Minimum 2 years of ambulatory care management program and/or case management experience.
- Knowledge of lines of business (LOB), including Commercial, United Health Care, Anthem Blue Cross, Blue Shield of California, Medicare Advantage, and ACO.
- Proficient in application of MCG for both inpatient and ambulatory care.
- Ability to interpret CMS, including Medicare Managed Care Manual.
- Excellent communication and interpersonal skills, with the ability to work effectively in a fast-paced environment.
- Certified Managed Care Nurses from the American Association of Managed Care Nurses.
- Bilingual or multilingual skills.
Loma Linda University is an equal opportunity employer and welcomes applications from diverse candidates. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.
