ECM Case Manager - LVN (Lancaster Region)

Astrana Health, Inc.•Monterey Park, CA

3d•$32 - $37•Hybrid

About The Position

The ECM Case Manager (LVN) provides clinically informed care management under the supervision and direction of the Manager, Strategy & Operations and RN Clinical Consultant. The role serves high-need Medi-Cal members enrolled in Astrana Health’s Enhanced Care Management (ECM) program, including people with chronic health conditions, behavioral health needs, substance use disorders, homelessness, or frequent hospitalizations. The Case Manager coordinates care, closes gaps in services, and connects members to clinical and community-based resources. The position works with internal teams, community-based organizations, and health plan partners to improve health outcomes, reduce health disparities, support continuity of care, and advance ECM program quality, compliance, and member engagement goals. The role uses a hybrid work structure, working both in the office and at home weekly, and may require weekly field visits to homes and community-based settings.

Requirements

Current, active, and unrestricted Licensed Vocational Nurse (LVN) license in the State of California.
At least 2 years of clinical experience, such as skilled nursing facility, home health, hospice, case management, or care coordination.
Ability to learn and navigate multiple case management software platforms and health plan portals while maintaining data accuracy.
Strong analytical, critical reasoning, organizational, and interpersonal communication skills.
Strong written and verbal communication skills.
Ability to multitask, work autonomously, and exercise sound clinical judgment.
Ability to maintain confidentiality and discretion when handling sensitive member, provider, and business information.

Nice To Haves

Associate’s or Bachelor’s degree in a health or human services-related field; equivalent combinations of education and progressively responsible clinical experience will be considered.
Familiarity with care plan goal setting, including development of problem statements, interventions, and goals.
Bilingual in Spanish.
Experience in a managed care environment, such as a health plan, IPA, or MSO.
Utilization Management or Hospice Case Management experience.
Working knowledge of DHCS, DMHC, NCQA, and CMS standards.

Responsibilities

Manage an assigned caseload of members with complex medical, behavioral, and social needs across multiple health plan contracts.
Conduct outreach to members regardless of case assignment or health plan to support ECM program engagement and team goals.
Meet members in person, including home visits, provider office visits, and community-based settings, to build trust, complete assessments, review care plans, and support engagement.
Complete initial comprehensive assessments, care plans, and interdisciplinary team conferences within timeframes set by the ECM leadership team.
Develop member-centered care plans with clear, measurable, achievable goals, and regularly review and update them based on member progress.
Support the RN Care Manager with clinical assessments, including comprehensive health assessments, medication reconciliation, post-hospital discharge assessments, and standardized screening tools such as PHQ-9, GAD-7, and the Edinburgh Postnatal Depression Scale.
Maintain accurate, timely documentation in case management software, Excel trackers, Monday.com boards, and health plan portals.
Coordinate transitions of care, including post-hospital and skilled nursing facility follow-up.
Communicate with primary care providers, specialists, behavioral health providers, hospitals, and community-based organizations to close referral loops and prevent gaps in care during transitions.
Review claims and authorizations and perform medication reconciliation in support of care coordination.
Work with internal and external partners to support ECM program success, including supporting members across all contracted health plans in addition to the individual caseload.
Connect members to social services, transportation, housing, food, and other community resources.
Use motivational interviewing, trauma-informed care, and harm-reduction approaches to support member engagement.
Identify barriers to treatment adherence and adjust care plans accordingly.
Educate members and caregivers about disease management and healthcare navigation.
Monitor member progress and caseload activity weekly, ensuring deliverables and outcomes are met.
Participate in audits, quality reviews, and team meetings as required.
Maintain accurate and honest timekeeping.
Support fellow care managers by sharing best practices and contributing to a positive, accountable team culture.
Perform other duties as assigned.