LVN Case Manager

Job Summary: 

We are seeking a dedicated and compassionate Licensed Vocational Nurse (LVN) Case Manager to join our dynamic healthcare team. The LVN Case Manager will be responsible for overseeing a diverse caseload, coordinating patient care, conducting medical necessity reviews, and ensuring regulatory compliance. The ideal candidate will possess excellent clinical skills, strong organizational abilities, and a passion for patient advocacy. This role involves both in-person and telehealth interactions to effectively manage treatment plans and patient relationships. 

Duties/Responsibilities: 

• Perform comprehensive assessments of patients' medical, psychosocial, and functional needs. 

• Develop, implement, and revise individualized care plans, monitoring progress toward patient goals. 

• Facilitate smooth transitions between different levels of care, including post-discharge visits and coordinate care between patients, ER, hospitals, and Urgent Cares. 

• Provide ongoing support and case management in accordance with the case/treatment plan and Transfer of Care. 

• Oversee the day-to-day administrative duties of the department. 

• Perform audits to ensure quality assurance. 

• Conduct clinical/medical necessity reviews and authorize services that meet medical criteria. 

• Act as a liaison between patients, families, healthcare providers, and community resources. 

• Maintain accurate and up-to-date patient records in accordance with regulatory and organizational standards. 

• Keep current with knowledge and understanding of applicable accreditation and regulatory statutes related to healthcare, managed care, and case management practice. 

• Performs other duties as assigned. 

Education and Experience: 

• Current and valid Licensed Vocational Nurse (LVN) license in the state of California required. 

• Associate or Bachelor’s degree in nursing, healthcare/business administration, or equivalent experience required. 

• Minimum of 2 years of clinical nursing experience in a medical setting (e.g., office, hospital, SNF, medical clinic) required. 

• Minimum of 1 year of experience in a managed care or healthcare environment related to Case Management. 

• Current BLS certification required. 

• Experience in managed care, palliative care, hospice, or neurology preferred. 

• Experience with virtual care and telemedicine preferred. 

• Knowledge and experience in working with homeless individuals and marginalized populations preferred. 

• Experience in acute care and/or ICU/CCU settings preferred. 

• Experience with Medicare and Medi-Cal environments preferred. 

Required Skills/Abilities:  

• Strong knowledge of medical terminology, healthcare systems, and case management principles. 

• Excellent communication, interpersonal, and organizational skills. 

• Proficiency in electronic health record (HER) systems and basic computer applications. 

• Certification in Case Management (e.g., CCMC or ARN) preferred. 

• Knowledge of Core Measures and basic statistics preferred. 

• Bilingual in English and Spanish preferred. 

Physical Requirements:  

• This position will require occasional travel to healthcare facilities and community resources to build relationships. 

• Prolonged periods sitting at a desk and working on a computer. 

• Must be able to lift up to 10 pounds at times.