Schedule: Remote | Candidates must currently reside in Southern California
Description:
Impresiv Health is seeking an experienced Care Manager, LVN to support care coordination and care management services within a managed care environment.
Under the general direction of department leadership, the Care Manager, LVN will work directly with members, medical groups, healthcare providers, hospitals, community agencies, and other entities involved in member care. This role is responsible for supporting coordinated care, serving as a resource for members and providers, and collaborating closely with a multidisciplinary care team throughout the care management process.
The Care Manager, LVN will also support organizational quality initiatives, including HEDIS, CAHPS, and NCQA accreditation goals.
What You Will Do:
- Serve as a resource for members and providers regarding care management and care coordination.
- Screen members for appropriate care management needs using approved screening tools, including Health Risk Assessments and other designated tools.
- Document screening findings and communicate relevant information to the appropriate members of the care team.
- Contribute to the development and modification of Individualized Care Plans (ICP).
- Review care plan recommendations with the RN Care Manager and other members of the Interdisciplinary Care Team (ICT), as appropriate.
- Educate members using approved care plans, educational materials, and resources.
- Communicate unexpected findings, changes in condition, or care concerns to the RN Care Manager and appropriate care team members.
- Assist members with immediate needs related to healthcare access, referrals, and authorizations.
- Serve as a member advocate and help resolve barriers to accessing appropriate care.
- Coordinate medical and behavioral health access needs with primary care providers, specialists, ancillary providers, and other healthcare services.
- Build and maintain effective working relationships with providers, community agencies, members, and internal teams through phone, in-person, email, fax, and other communication channels.
- Utilize evidence-based communication strategies, including Motivational Interviewing, to promote member engagement and collaboration.
- Work collaboratively with members and their medical and behavioral health teams to increase member participation and engagement in managing their overall health.
- Collaborate with multidisciplinary care team members on member cases, responsibilities, care coordination activities, and resolution of care-related concerns.
- Participate in continuous quality improvement initiatives and projects.
- Identify and address HEDIS gaps in care and support initiatives designed to improve member health outcomes.
- Support quality initiatives related to HEDIS, CAHPS, and NCQA accreditation.
- Maintain high standards of ethical conduct, professionalism, and confidentiality when interacting with members, providers, colleagues, and community partners.
- Perform additional duties as required to support department and health plan operational needs.
You Will Be Successful If:
- You have a strong understanding of healthcare delivery systems and managed care processes.
- You can effectively read, review, and interpret healthcare and member data.
- You are able to analyze problems and develop appropriate plans, solutions, and courses of action.
- You can establish and maintain collaborative working relationships with members, providers, healthcare professionals, and colleagues at all levels of an organization.
- You demonstrate strong written and verbal communication skills.
- You are comfortable communicating through phone, email, fax, digital platforms, and in-person interactions.
- You are highly organized and detail oriented.
- You can maintain confidentiality of member information and organizational business matters.
- You are comfortable working as part of a multidisciplinary care team.
- You are able to advocate for members and assist with resolving barriers to healthcare access.
- You can effectively utilize evidence-based communication approaches such as Motivational Interviewing.
What You Will Bring:
- Three or more years of care management experience within a healthcare delivery setting.
- High school diploma or GED required.
- Active, unrestricted, and unencumbered Licensed Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians.
- Working knowledge of healthcare delivery systems.
- Proficiency with Microsoft Office Suite and other supportive healthcare technology.
- Strong written and verbal communication skills.
Preferred Qualifications:
- Experience working within an HMO or Managed Care environment.
- At least one year of clinical experience within an acute care facility, skilled nursing facility, home health setting, or clinic.
- Associate degree from an accredited institution.
- Valid California Driver's License.
About Impresiv Health:
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do: provide tangible results that add immediate value, at a rate that cannot be beaten.
Your success matters, and we know it.
That s Impresiv!