Case Manager (LVN or RN)

Case Manager (LVN or RN)Astrana Health is looking for a LVN Case Manager who has the ability to commute to our Monterey Park office at 1600 Corporate Center Drive. This position works standard day hours M-F, and we are willing to train a RN or LVN with no case management experience! You will have the ability to work with pediatrics and/or adult populations depending on business need.What You'll DoComply with Case Management Department's policies and procedures95 - 100% compliance with Utilization Management health plan delegation standards for Case ManagementUtilize Milliman Care Guidelines criteria for appropriateness of transition to care by level of skilled needs and acute rehab for post discharge planCollaborating with Hospitalists, case managers, and discharge planners to establish discharge plans at time of admissionResponsible for coordinating the required initial and concurrent reviews based on the review of medical records received and daily accurate reporting of all inpatient admissions to Medical Director and Manager and/or Supervisor of Case Management DepartmentReview of medical records and/or other documentation to determine medical necessity, appropriateness and level of care utilizing Milliman Care and other appropriate GuidelinesAssess, plan, implement, coordinate, monitor, and evaluate all options and services with the goal of reducing hospital readmission • Attends/coordinates Case Management meetings on and off-site as necessaryInteracts with the providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirementsAttend to provider and interdepartmental calls in accordance with exceptional customer serviceMaintain good relationships with health plans, hospitals and medical directors. Resolve problems that arise with any IPA medical directorsReport to Manager and/or Supervisor of Case Management on activities and/or problems occurring throughout the dayAvailable for Hospital on site Case ManagementOther duties as assignedQualificationsActive Registered Nurse (RN) license in California OR active Licensed Vocational Nurse (LVN) license in CaliforniaExperience using Microsoft applications such as Word, Excel and OutlookAt least two (2) years of clinical experience as an RN/LVNYou're great for this role if:Excellent analytical critical reasoningProven ability to prioritize multiple responsibilities simultaneously in a fast-paced, changing environment while meeting deadlinesAbility to educate and train staff members and other departments as neededExperience using EZCAPStrong communication and customer service skillsEnvironmental Job Requirements and Working ConditionsOur organization follows a hybrid work structure where the expectation is to work both onsite and at home on a weekly basis. The home office is located at 1600 Corporate Center Dr, Monterey Park, CA 91754.This role will require visiting patients in our partnered hospitals 2-3 times a week.The national target pay range for this role is between $31.00 - $45.00 (LVN - $31.00-38.00; RN - $39.00-45.00) per hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.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 View email address on click.appcast.io to request an accommodation.The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.About Astrana Health, Inc.Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.