Care Manager, LVN

Responsibilities Serve as a resource for IEHP members and providers for care management and care coordination Screen members for appropriate care management needs, document findings, and communicate with the care team Use approved screening tools, including Health Risk Assessments, to contribute to member assessment Contribute to the development and modification of Individualized Care Plans Review care plan recommendations with RN Care Manager Team Members and Interdisciplinary Care Team members Educate members according to approved plans and materials Communicate unexpected results to the RN Care Manager Team Member and other ICT members Assist members with access, referrals, and authorizations Advocate for members and coordinate medical and behavioral health access issues with PCP offices, specialists, and ancillary services Build and maintain relationships with providers, community agencies, and internal colleagues through in-person, phone, email, and fax communication Use evidence-based communication strategies, including Motivational Interviewing, to resolve conflicts and coordinate tasks Engage with members in person and by phone to promote collaboration with medical and behavioral teams and increase members' control over their whole health Participate in continuous quality improvement initiatives, including identifying and addressing HEDIS gaps and testing practices to improve member health outcomes Perform other duties required to support Health Plan operations and department business needs Requirements Three (3) or more years of care management experience in a health care delivery setting required Current IEHP Team Members who have worked at least two (2) years in the Care Management department and are currently successful in their work performance during the last two (2) years, may be considered in lieu of the minimum three (3) year experience requirement Experience in an HMO or Managed Care setting preferred Minimum one (1) year clinical experience in an acute care facility, skilled nursing facility, home health or clinic setting preferred High school diploma or GED required Associate’s degree from an accredited institution preferred Active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required Valid California Driver's License preferred Working knowledge of health care delivery systems Working knowledge of PC applications including MS Office Suite and other supportive technology Written and oral communication skills Ability to read and interpret data Ability to analyze problems and formulate appropriate plans, solutions, and courses of action Ability to establish and maintain cooperative working relationships with individuals at all levels of the organization and members Ability to maintain confidentiality of members and related entity business matters Detail-oriented Ability to work in a hybrid schedule with remote work on Monday and Friday and onsite work Tuesday through Thursday in Rancho Cucamonga, California Core Competencies Demonstrates expertise in care management and coordination, utilizing Health Risk Assessments and evidence-based communication strategies to enhance member health outcomes. Proficient in building relationships with providers and community agencies while advocating for member access to medical and behavioral health services. Highest-signal resume keywords Care Management Experience Health Risk Assessment Vocational Nurse (LVN) License Motivational Interviewing HMO or Managed Care Experience Hard Skills Care Coordination Individualized Care Plans Data Analysis Quality Improvement Initiatives Health Care Delivery Systems Soft Skills Written Communication Oral Communication Detail-Oriented Problem Solving Relationship Building Certifications & Qualifications Vocational Nurse (LVN) License High School Diploma or GED Industry Keywords Managed Care HEDIS Behavioral Health Acute Care Facility Skilled Nursing Facility Tools & Technologies MS Office Suite Screening Tools Evidence-Based Communication Strategies #J-18808-Ljbffr