Case Manager Nurse LVN

Full time Case Manager Nurse LVN openings in Houston, TX 77027 area with a major healthcare company! Starting ASAP!! Apply now with Luke H. at A-line!!

Job Summary : LVN to support high-risk, high-needs patients in the home and facility-based setting. This unique role will provide the opportunity to interact with physician and health care leaders on a regular basis.

In addition to navigating members across the care continuum, you will help support clinical program developments and initiatives.

You will be a nurse, an advocate, a navigator, and a leader!

Pay Rate : $30 -$35 per hour

Hours : Monday Friday 8 AM 5 PM

Job Duties :

• Provide home visits to high-risk members for evaluation of needs in an effort to reduce barriers to care. Ensure supportive services are in place to reduce inappropriate utilization patterns and condition exacerbation.
• Assist members with accessing needed services
• Identifies problems and acts to anticipate and avoid complications.
• Instructs patient and family on proper care and refers patient back to physician or other health care team members as needed
• Will escalate findings to assigned physician and / or medical director
• Conduct facility visits to facilitate pro-active discharge planning and timely transition to lower level of care
• Coordinate with facility and home health agency care managers to support collaborative care and best patient outcomes.
• Will continuously assess for return to acute events and will involve physician leadership as appropriate.
• Direct members back to PCP post-discharge and arrange for necessary referrals and services
• Will be observant to concerning facility trends and sub-standard care delivery and will report these findings back to manager
• Collaborate with internal care management peers and other disciplines within the organization to support assigned members
• Attend provider practice meetings to give updates on their patient population. Will address concerning spend and utilization patterns and will support change in coordination with Quality Practice Advisor peers.
• Identify and report community needs and trends back to leadership to support program development. Will suggest program implementations and enhancements to resolve community care gaps.
• Report out to ACO and IPA physician leadership on a regular basis.

Required :

• 4+ years of experience as an LVN required; 1+ year of facility-based nursing experience is preferred
• Professional skills interacting with physicians and healthcare leadership; Prior health plan is experience is a plus
• Must have accountability, as assessments and interactions must be logged, documented, and submitted
• Candidate must have strong critical thinking skills and the ability to develop clinical action plans and escalations
• Must have experience using Outlook, Excel, Word, and PowerPoint; EHR experience preferred

Why Apply :

• Full benefits available after 90 days : Medical, Dental, Vision, Life, Short-term Disability
• 401k after 1 year of employment : With employer match and profit sharing
• GREAT Hours! Monday through Friday, 40 hours per week, No Weekends
• Competitive Pay Rate!

Keywords : LVN, Licensed Vocational Nurse, Clinical Care, Case Manager, Case Management, Utilization Review, Utilization Management, LPN, ADN, Clinical Service, Clinical Coordinator, Nurse, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Reimbursement Counselor, Medical Customer Service, Healthcare, Inbound Calls, Outbound Calls, Medicare, Medicaid.