Care Manager, LVN (Remote)

Inland Empire Health Plan•, CA

10d•$63,898 - $83,075•Remote

About The Position

Under the general direction of department leadership, the Care Manager, LVN is responsible for working directly with the IEHP members, IPA medical groups, providers, hospitals, community agencies, and other entities supporting member care to ensure coordinated care and serve as a resource person for internal and external entities. The Care Manager, LVN works closely with the multidisciplinary care team to support members during the care coordination and care management process. The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Requirements

Three (3) or more years of care management experience in a health care delivery setting required
High school diploma or GED required
Possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required
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
Proven ability to: Read and interpret data
Proven ability to: Analyze problems and formulate appropriate plans, solutions, and courses of action
Proven ability to: Establish and maintain cooperative working relationships with individuals at all levels of the organization and members
Proven ability to: Maintain confidentiality of members and all related entity business matters of the organization
Proven ability to: Be detail oriented

Nice To Haves

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 for this position in lieu of the minimum three (3) year experience requirement
Experience in an HMO or experience in Managed Care setting preferred.
Minimum one (1) year clinical experience in and acute care facility, skilled nursing facility, home health or clinic setting preferred
Associate’s degree from an accredited institution preferred
Valid California Driver’s License preferred

Responsibilities

Serve as a resource for IEHP members and providers for care management and care coordination.
Screen members for appropriate care management needs, documenting findings and communicating with the rest of the care team. Use approved screening tools which contribute to the assessment (i.e., Health Risk Assessment or other designed tools).
Contribute to the development and modification of the Individualized Care Plan (ICP) including: Review ICP recommendations with RN Care Manager Team Member and other Interdisciplinary Care Team (ICT) members as appropriate. Educate members according to approved plan and material content. Communicate unexpected results with RN Care Manager Team Member and other ICT members as appropriate.
Assist members with immediate needs with regard to access, referrals and authorizations. Act as a member advocate at all times. Assist with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services.
Model the highest ethical behavior in relationships with co-workers, supervisors, members, providers, and colleagues in the community.
Build and maintain a positive working relationship with providers, community agencies, and internal colleagues through all modes of communication (e.g., communication via in-person, over the phone, and through digital means such as email and fax). Promote a collaborative and effective working environment within the Team by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on member case discussions.
Engage with members, both in-person and on the phone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the member and his or her medical/behavioral team, as well as to increase the member’s sense of control over their whole health.
Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as by identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving member health outcomes.
Perform any other duties as required to ensure Health Plan operations and department business needs are successful.