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Lead Case Manager-LVN-ACO / CCM

Lead Case Manager-LVN-ACO / CCM

Clinica Sierra VistaBakersfield, CA, US
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Job Description

Job Description

Clinica Sierra Vista is excited to be one of the largest Federally Qualified Health Centers in the Nation! We’re honored to serve the men and women of the fields. We also offer care and support to the inner city, the rural and isolated, those of low, moderate, and fixed incomes, and families from an array of cultural backgrounds who speak several languages. We don’t inquire about immigration status because we simply don’t need to know. If you come to us, we will treat you like any other patient.

As we grow our team, we are looking for individuals who believe the patient is always #1.

Why work for us?

  • Competitive pay which matches your abilities and experience
  • Health coverage for you and your family
  • Generous number of vacation days per year
  • A robust wellness plan and health club discounts
  • Continuing education assistance to grow and further your talents
  • 403(B) plan with company matching

Intrigued? We’d love to hear from you! Please review the job details below and then click “apply.”

We're looking for someone to join our team as a Lead Case Manager-LVN who :

The Lead Case Manager for value based programs such as Chronic Care Management (CCM) and ACO services (for patients enrolled in Medicare) is responsible for coordinating with external CCM and ACO supervisors and programs, serving Fresno and Kern County. This role involves managing day-to-day activities, ensuring the efficient use of resources, and maintaining high performance standards while meeting the Centers for Medicare and Medicaid Services (CMS) program requirements. The Lead Case Manager will work closely with leadership, care teams, and external partners to drive team performance, ensure compliance, and contribute to achieving programmatic goals aligned with Centers for Medicare and Medicaid Services (CMS) initiatives.

Essential Functions :

Operational Oversight & Supervision :

  • Work with the CAO and other department directors to ensure compliance with agency, grant, and regulatory requirements, including OSHA, ADA, CLIA, HIPAA, HRSA, TJC, NCQA, DHCS, FQHC and all CMS specific standards
  • Report and address any legal, privacy, safety, or risk management issues related to CCM and ACO services.
  • Track and evaluate CCM and ACO program successes through data-driven decision-making, patient engagement, and quality assurance reviews.
  • Oversee CCM staff access, including client service specialists, medical assistants, case managers, and outreach workers, ensuring compliance with CCM and ACO program guidelines.
  • Monitor staff schedules and PTO requests to always ensure adequate coverage. (If applicable)
  • Ensure timely submission of staff payroll and accounting records to facilitate prompt payroll processing. (If applicable)
  • Perform introductory and annual employee reviews and competency assessments, and provide constructive feedback to support organizational and professional growth. (If applicable)
  • Collaboration & Communication :

  • Address patient needs, including complaints, problem-solving, and de-escalation, ensuring timely resolution per CSV policies.
  • Represent Clinica Sierra Vista’s Value Based Programs or partnerships such as CCM.
  • Deliver presentations to promote public awareness of CCM and ACO services and eligibility criteria.
  • Manage in basket message from external partners.
  • Provide guidance and support to CCM and ACO program staff to ensure quality patient care, customer service, and coordination of care for internal and external clients. This includes providing access to CSV resources as needed.
  • Problem-Solving & Decision-Making & Quality :

  • Analyze and improve key quality indicators to prioritize, organize, and coordinate strategies for CCM and ACO program growth, marketing, and patient engagement.
  • Assess processes and workflows to ensure efficient and client-centered CCM and ACO program care delivery.
  • Identify, track, and report organizational and performance improvement activities within the CCM and ACO services framework.
  • Ensure staff adherence to Clinica Sierra Vista policies and CCM and ACO specific procedures while proactively addressing compliance issues.
  • Collaborate with discipline-specific supervisors for clinical performance management. Set, model, and reinforce clear expectations, foster open communication, and provide problem-solving support.
  • You'll be successful with the following qualifications :

  • Education : Graduation from an accredited School of Vocational Nursing.
  • Experience : 5 years of experience in a managerial or supervisory role, preferably Clinica Sierra Vista or Medi-Cal program setting.
  • Strong leadership, organizational, and communication skills.
  • Ability to motivate and manage a multidisciplinary team.
  • Excellent problem-solving and decision-making capabilities.
  • Clinica Sierra Vista values human rights, goodwill, respect, inclusivity, equality, and recognizes that the organization derives its strength from a rich diversity of thoughts, ideas, and contributions. As leaders in healthcare industry, we aspire to be an employer of choice by promoting an organizational culture that reflects these core values. We seek to attract, develop, and retain a talented and dedicated workforce where people of diverse races, genders, religions, cultures, political affiliations and lifestyles thrive. Our goal is to create a welcoming and inclusive environment that empowers our employees to provide the highest level of service to our community of residents and businesses; they’re counting on us.

    Clinica Sierra Vista is an equal opportunity employer and strives to attract qualified applicants from all walks of life without regard to race, color, ethnicity, religion, national origin, age, sex, sexual orientation, gender identity, gender expression, marital status, ancestry, physical disability, mental disability, medical condition, genetic information, military and veteran status, or any other status protected under federal, state and / or local law. We aim to create an environment that celebrates and embraces the diversity of our workforce. We welcome you to join our team!

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