CASE MANAGER (LPN/LVN)- Full Time

Riverside Medical Clinic Opportunity

Come and join the RMC Family! We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Quality healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care.

SUMMARY: Identifies, plans, and coordinates high-risk patient care (frail, chronic disease, catastrophic injury) in an ambulatory setting. Reviews referrals and applies the UM standards for patient care. Ensures continuity of care across the continuum. Promotes and evaluates quality and cost-effective outcomes.

Qualifications

EDUCATION and/or EXPERIENCE: High School Diploma or GED required. Graduate of an accredited LVN Program. A.A., Diploma preferred. One to two years related experience and/or training; or equivalent combination of education and experience.

CERTIFICATES, LICENSES, AND REGISTRATIONS: Current California LVN license.

ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job's purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable.

• Assess available information to determine patient needs. Develop and initiate comprehensive, multidisciplinary treatment plans.
• Consult and coordinate treatment plans with providers.
• Establish and implement with patient and health care team measurable goals within the proposed treatment plan.
• Verify patient and medical group eligibility and benefits. Monitor utilization of resources and readjust treatment plans when appropriate.
• Monitor patient responses to treatment plans.
• Monitor patient outcomes to determine patient satisfaction as well as the effectiveness and efficiency of the treatment plans.
• Orient providers to managed care and RMC goals and philosophies.
• Initiate required QRM reports per company policy.
• Utilize established criteria for authorization guidelines.
• Communicate problems with patients and physicians to resolve issues in a timely manner.