Care Manager I - LVN
About The Position
We are seeking a passionate Care Manager I - LVN to join our Population Health team in the Houston, Texas area. In this full-time role, you will play a key part in coordinating care, supporting patients through transitions of care, and addressing barriers that impact overall health and wellness. As a Care Manager I - LVN, you will help patients navigate their healthcare journey by coordinating services, promoting preventive care, and ensuring timely access to the resources they need to achieve better health outcomes. Working closely with providers, health plans, patients, and interdisciplinary care teams, you will contribute to improving quality of care, enhancing the patient experience, and supporting positive clinical outcomes. This position reports directly to the Manager of Care Management and offers an opportunity to make a meaningful impact in a growing, patient-centered organization.
Requirements
- Active LVN license in the State of Texas required.
- Minimum of three (3) years of clinical nursing experience, preferably in case management, care coordination, population health, utilization management, or a related healthcare setting required.
- Minimum of three (3) years of hospital, acute care, or inpatient experience strongly preferred.
- Minimum of two (2) years of utilization management experience, including application of evidence-based clinical criteria and health plan benefits.
- Knowledge of Medicare, Medicaid, managed care, and community-based resources.
- Strong assessment, care coordination, documentation, and communication skills.
- Proficiency with electronic health records (EHRs) and care management systems.
Nice To Haves
- Certified Case Manager (CCM) certification preferred.
- Experience working within value-based care, managed care, ACO, IPA, MSO, or population health environments preferred.
Responsibilities
- Identifies, arranges for, and monitors appropriate community services based on a working knowledge of Medicare, Medicaid, and other entitlement programs
- Coordinate and facilitate patient care through assessment, evaluation, planning, and implementation
- Communicate patient needs to a variety of care team members and follow up accordingly
- Manage discharge plans upon completion of treatment
- Work collaboratively with patients, families, physicians, nurses, and the multidisciplinary team to ensure high quality care
- Act as the patient's advocate as it relates to insurance coverage and financial assistance
- Maintain the patient's comprehensive clinical record through detailed documentation
- Coordinate an interdisciplinary approach to support timely access to appropriate care, facilitate continuity of care among providers and improve utilization of appropriate resources
- Apply established principles of care transition and follow patient through continuum of care as well as coordinate a warm hand-off to the appropriate provider and/or health plan for necessary involvement of continuation of care and services
- Assists Care Management Manager and participates in all internal and external audits
- Primary liaison with all contracted health plans for case management activities
- Ensure the privacy and security of PHI (Protected Health Information) as outlined in Medical Group/ MSO policies and procedures related to HIPAA compliance
- Participate in special projects and perform other duties as assigned.
Benefits
- Equal Employment Opportunity and Affirmative Action employer
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
