Episodic Case Manager, LVN
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Job Description
Episodic Case Manager LVN coordinating assessments, referrals, and care plans for MedPOINT Management’s healthcare members. Advocating for patients across the care continuum.
Responsibilities:
- Assess, plan, implement, monitor, and evaluate options and services to develop patient-focused action plans
- Act as patient advocate throughout the continuum of care and facilitate communication among physicians, patients, and families
- Monitor patient care to ensure quality care using standards of care and practice guidelines
- Perform medical, functional, safety, nutritional, and psychosocial assessments for assigned caseloads
- Document issues, problems, interventions, and follow-up notes in the preferred documentation module
- Communicate sensitively and timely with patients, families, and significant others regarding patient care
- Identify support systems from family and community resources
- Participate in Interdisciplinary Care Team, Case Management, and IPA meetings/rounds as needed
- Coordinate specialist visits, durable medical equipment, home health, prior authorization, and other member needs
- Collaborate with the Social Work team to coordinate care and services
- Refer members to eligible Health Plan programs, including Complex Case Management, Disease Management, Palliative Care, and MLTSS
- Maintain communication with health plans, physicians, hospitals, extended care facilities, members, MPM departments, and co-workers regarding referrals
- Ensure cases are coded accurately for reporting of members referred to health plan programs
- Adhere to HIPAA confidentiality regulations and policies
- Assist with orientation and training for new employees as needed
- Perform other assigned tasks and show initiative
Requirements:
- Current California RN/LVN License
- Acute Care experience
- 1–2 years’ experience in Basic/Complex Case Management a plus
- 1 year experience in Managed Care
- Understanding of the managed care philosophy, including advanced knowledge of HMO policies and procedures and the managed care industry
- Familiarity with Case Management Policies and Procedures, standards of practice and its function
- Ability to triage, prioritize, and identify urgent versus non-urgent matters
- Ability to manage diverse areas of understanding and interface effectively with employees, members, employers, MPM personnel, and providers
- Basic office and computer skills; computer literacy
- Detail orientation and strong verbal and written communication skills
- Bilingual is a plus
- EZ-CAP and ESSETTE knowledge is a plus
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Vision insurance
- Wellness resources
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