Care Manager I - LPN (Maryland)
Astrana Health, Inc.•Monterey Park, CA
•$31 - $40•Remote
About The Position
The Care Manager I - LPN position is within the Health Services department and focuses on developing and initiating client-centered care plans, coordinating patient care, and advocating for patients. This role involves managing discharge plans, maintaining clinical records, and ensuring continuity of care through an interdisciplinary approach. The position also serves as a liaison with health plans and ensures the privacy and security of protected health information (PHI).
Requirements
- Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN) required
- Two (2) years’ utilization management experience applying evidence-based clinical criteria and benefit plans required
- Three (3) years’ clinical experience, preferably in case management or a related area, required
Nice To Haves
- Bachelor’s degree in nursing or a related health services field
- Certified Case Manager (CCM) certification preferred
- Tagalog or Ilocano language skills preferred
Responsibilities
- Develop and initiate client-centred, comprehensive Individual Care Plans consistent with programme guidelines, policies and procedures.
- Identify, arrange and monitor appropriate community services, using strong knowledge of Medicare, Medicaid and other entitlement programmes.
- Coordinate and facilitate patient care through assessment, evaluation, planning and implementation, communicating needs to the care team and following up as required.
- Manage discharge plans and work collaboratively with patients, families, physicians and nurses to ensure high-quality care.
- Act as the patient’s advocate regarding insurance coverage and financial assistance.
- Maintain a comprehensive clinical record through detailed, accurate documentation.
- Coordinate an interdisciplinary approach to support timely access to appropriate care, ensure continuity among providers and optimise use of resources.
- Apply established care transition principles, following members through the continuum of care and coordinating warm hand-offs to appropriate providers and/or health plans.
- Assist the UM Manager and participate in all internal and external audits.
- Serve as primary liaison with contracted health plans for case management activities.
- Protect the privacy and security of PHI in line with Medical Group/MSO policies and HIPAA requirements.
- Perform other duties and special projects as assigned.
Benefits
- Equal Employment Opportunity and Affirmative Action employer
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
