Concurrent Care Management LVN

LSMA Management Inc • San Bernardino, CA

5d • $35 - $40 • Hybrid

About The Position

The Concurrent Care Management LVN is responsible for supporting inpatient and post-acute care coordination and concurrent review activities to ensure medically appropriate, timely, and cost-effective utilization of healthcare services for members of a California Managed Services Organization (MSO). Under the direction of the Inpatient/Post-Acute Manager and RN leadership, the Concurrent Care Management LVN performs concurrent review, monitors inpatient and post-acute utilization, supports discharge planning, facilitates transitions of care, and coordinates services across the continuum of care. This role collaborates closely with hospitals, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), long-term acute care hospitals (LTACHs), home health agencies, physicians, and interdisciplinary care teams. The Concurrent Care Management LVN supports organizational goals related to quality outcomes, appropriate utilization, reduced readmissions, regulatory compliance, and continuity of care for Medicare Advantage, Medi-Cal, Commercial, and other managed care populations.

Requirements

• High School diploma or equivalent required.
• Graduate from an accredited vocational nursing program.
• At least two years of clinical experience as an LVN.
• CA LVN license and BLS Certification.
• Knowledge of inpatient and post-acute care coordination processes.
• Understanding of utilization management and medical necessity principles.
• Knowledge of SNF, IRF, LTACH, home health, and hospice care settings.
• Ability to monitor patient progress and identify barriers to discharge.
• Strong clinical documentation and organizational skills.
• Ability to work independently and collaboratively.
• Strong communication and interpersonal skills.
• Ability to manage multiple cases simultaneously.
• Proficiency with electronic medical record and care management systems.
• Knowledge of managed care and healthcare delivery systems in California.
• Understanding of HIPAA and patient confidentiality requirements.

Nice To Haves

• Additional training or coursework in case management, utilization management, or care coordination.
• Experience in concurrent review or inpatient utilization management.
• Experience working in a Managed Services Organization (MSO), IPA, or health plan.
• Experience with Medicare Advantage and Medi-Cal managed care populations.
• Experience using electronic medical records and care management systems.
• Experience coordinating post-acute services.

Responsibilities

• Perform concurrent review.
• Monitor inpatient and post-acute utilization.
• Support discharge planning.
• Facilitate transitions of care.
• Coordinate services across the continuum of care.
• Collaborate with hospitals, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), long-term acute care hospitals (LTACHs), home health agencies, physicians, and interdisciplinary care teams.
• Support organizational goals related to quality outcomes, appropriate utilization, reduced readmissions, regulatory compliance, and continuity of care for Medicare Advantage, Medi-Cal, Commercial, and other managed care populations.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree