Job Description
Job Description
Description
We are currently seeking a highly motivated LVN Lead Care Manager for our Enhanced Care Management (ECM) team. ECM is a Medi-Cal benefit that links high risk members to various resources in the community. You will be responsible for doing assessments and creating care plans based on those assessments for your caseload, as well as following up with members throughout their time in the ECM program.
We are ideally seeking candidates who have prior experience with care management, complex case management, home health, dialysis, D-SNP case management, or managed care.
Our Values :
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
Manage a caseload of 50-100 Medi-Cal members with complex medical and social needs, adhering to DHCS and Model of Care requirements.Conduct timely outreach, comprehensive assessments (HRA), risk stratification, and individualized care planning.Coordinate transitions of care, including hospital discharges and PCP follow-ups, ensuring continuity and quality of care.Collaborate with community health workers and interdisciplinary teams to address medical, behavioral, and social needs.Perform medication reconciliations, review claims / authorization data, and evaluate assessment findings using evidence-based guidelines.Identify barriers to care, provide education using motivational interviewing and trauma-informed approaches, and adjust care plans based on member readiness and outcomes.Connect members to social services (e.g., transportation, housing, support programs) and facilitate care across settings (home, hospital, SNF, community).Participate in interdisciplinary team meetings, health plan audits, and seminars, ensuring compliance with organizational and regulatory standards.Other duties as assigned.Qualifications
Current and active LVN CA licenseExperience with clinical issues and guidelinesExcellent analytical, critical reasoning, organizational and interpersonal communication skillsStrong written and oral communication skillsAbility to multi-task, work autonomously, and think outside the boxAbility to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information is required.Proficient with Microsoft Office (Word, Excel, Power Point)You're great for this role if you have :
Knowledge of enhanced case management, SNP case management, complex case managementExperience in managed care environment – health plans, IPA, or MSO1+ years of Case Manager experienceBasic knowledge of DHCS, DMHC, NCQA, ICE, and CMS standardsBachelor's degreeEnvironmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.The total compensation target pay range for this role is between $28 - $38 per hour, depending on credentials and experience. The salary range represents our national target range for this role.Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.
