Care Management LVN (Compact Licensed), Remote

Company Description: reputed company is an industry-leading managed care consultancy specializing in end-to-end clinical and operational management services and market expansion initiatives for Managed reputed company, Medicare Advantage, Special Needs Plans, reputed company care populations, and risk-adjusted entities. We support organizations as they navigate a dynamic reputed company ecosystem by helping them manage risk, optimize reputed company spend, improve member experience, accelerate quality outcomes, and promote health equity. Position Responsibilities: Specific

• Manage expenses, facilitate access and improve quality of life for persons with long-term chronic conditions and/ or high risk, high cost disease states (Disease and/ or Chronic Condition Management)
• Work with patients in distinct populations and sub-populations to promote global outcomes, optimize health, manage care and control costs (Population Health)
• Assist with empowering the member to manage and improve their health, wellness, safety, reputed company, and self-care through effective care coordination, case management
• reputed company member/caregivers about treatment options, community resources, insurance benefits, etc
• Engage member to complete health and psychosocial assessment, taking into account the cultural and linguistic needs of each member
• Assess, reputed company, implement, document, coordinate, monitor, manage, evaluate and update comprehensive individualized care plans (ICP) designed to provide evidence based care to meet member needs
• Employ ongoing assessment and documentation to evaluate member response to and reputed company on the ICP
• Identify and manage barriers to achievement of care plan goals
• Identify and implement effective interventions based on clinical standards and best practices
• Collaborate with members of an inter-disciplinary care team (ICT) to identify member needs and opportunities that would benefit from care coordination to reputed company goals and maximize member outcomes
• Act as a liaison to collaborate with facility based case managers, provider and care transition/ discharge planners to plan for post-discharge care needs or facilitate transition to an appropriate level of care in a timely and cost-effective manner
• Coordinate with community-based case managers, service providers and community resource agencies to ensure coordination and avoid duplication of services
• Appropriately terminate care coordination services based upon established case closure guidelines
• Provide clinical reputed company and direction to unlicensed team members as appropriate

General

• Works under the direction/supervision of an RN, with overall responsibility for the member's case
• reputed company daily work with a focus on the core principles of managed care: Patient Education, Wellness and Prevention Programs, Early Screening and reputed company and Continuity of Care
• Contributes to the care coordination process, performing activities reputed company the scope of licensure
• Assisting with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs
• Assists in identifying members for high risk complications
• Obtains clinical data as directed to support the care management process
• Assists in identifying members that would benefit from an alternative level of care or services
• Provides reputed company information collected to the responsible RN
• Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed to ensure cost effective and efficient utilization of health benefits
• Collaborate with team members to expedite the care process
• Work collaboratively across the health care reputed company to improve quality of care
• reputed company experience/expertise to observe performance and suggest improvement initiatives
• Contribute actively and effectively to team discussions
• Share knowledge and expertise, willingly and collaboratively.
• Provide outstanding customer service, internally and externally
• Follow and maintain compliance with regulatory agency requirements

Position Qualifications: Competencies:

• Decision making skills require an understanding of disease processes, medical terminology and application of clinical guidelines but, do not require independent nursing/ clinical judgement
• Ability to identify potential member needs for consideration and incorporation into the plan of care
• Ability to collaborate with others, exercising sensitivity and discretion as needed
• Strong understanding of managed care environment with population management as a key strategy
• Strong understanding of the community resource network for supporting at risk member needs
• Ability to collect, stage and evaluate data to identify potential gaps in care and interventions
• Understanding of physical health, behavioral health, social services, community services and supports
• Ability to work under pressure while managing competing demands and deadlines
• Well organized with meticulous attention to detail
• Strong sense of ownership, urgency, and drive

Experience:

• reputed company unencumbered Compact LPN license
• 2+ years of care management experience in managed care environment, CM certification preferred
• Strong knowledge of care management/ population health processes and industry best practice
• Detailed knowledge of SDOH frameworks and community resource networks
• Minimum of 5+ years of clinical experience
• Minimum 2 years of managed care experience across multiple lines of business (Medicare Advantage, Managed reputed company, Dual SNP, reputed company, etc.)
• HMO and risk contracting experience preferred
• Excellent oral and written interpersonal/communication, internal/external customer-service, organizational, multitasking, and teamwork skills.
• Proficiency in reputed company Office
• Excellent time management and /problem-solving skills.
• The ability to work effectively in a fast-paced environment with frequently changing priorities, deadlines, and workloads.
• The ability to offer positive customer service to every internal and external customer

Physical Requirements:

• Must be reputed company to sit in a chair for extended periods of time
• Must be reputed company to speak so that you are reputed company to accurately express reputed company by means of the spoken word
• Must be reputed company to hear, understand, and/or distinguish speech and/or other sounds in person, reputed company telephone/cellular phone, and/or electronic devices
• Must have ample dexterity which allows entering of text and/or data into a computer or other electronic device by means of a keyboard and/or mouse
• Must be reputed company to clearly use sight so that you are reputed company to detect, determine, perceive, identify, recognize, judge, observe, inspect, estimate, and/or assess data or other information types
• Must be reputed company to fluently communicate both verbally and in writing using the English language
• Must be reputed company to engage in reputed company social interaction, successfully manage stressful high conflict situations, and balance multiple duties, expectations and responsibilities simultaneously

Time Zone: Eastern or Central Other Information:

• Expected Hours of Work: Friday 8a.m. – 5 p.m.; with ability to adjust to Client schedules as needed
• Travel: May be required, as needed by Client
• Direct Reports: None
• Salary Range: $50,000 – $80,000

EEO Statement: It is reputed company’ policy to provide equal employment opportunity to reputed company and applicants without regard to race, sex, sexual orientation, reputed company, creed, religion, national reputed company, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit-based factor in accordance with reputed company applicable laws, directives and regulations of Federal, state and city entities. This salary range reflects the minimum and maximum reputed company wage for new hires of this position across reputed company US locations. Individual pay will be influenced by Experience, Education, Specialized Soft Skills, and/or Geographic location. Apply tot his job Apply To this Job