Health Plan Case Manager LVN

Trinity Health • Fresno, CA

6d • $29 - $41

About The Position

Reporting to the Director CVHP Operations, CVHP Operations, this position is responsible for outreaching and scheduling patients due for annual wellness visits for all CVHP members. The position acts as a liaison between RN Case Managers, Medical Directors, patients, physicians, community resources, and other healthcare providers to ensure timely care coordination for patients. The incumbent ensures members and providers are educated on annual wellness visit requirements and any additional health care gaps identified by the CMS STARs scorecard for each member.

Requirements

• High school diploma or equivalent is required.
• Graduate of an accredited Licensed Vocational Nurse (LVN) program is required.
• Current licensure as a Licensed Vocational Nurse (LVN) in California is required.
• Current American Heart Association (AHA) Healthcare Provider CPR card is required.
• Excellent communication, critical thinking, creative problem-solving, organizational, and planning skills are required.
• Must be self-directed and able to work under pressure, balance evolving priorities, meet deadlines in a diverse environment with frequent interruptions and a demanding workload, and organize and adapt work priorities as they change.
• Familiarity with standard desktop and Windows-based computer systems, including email, e-learning, intranet, and computer navigation, is required.

Nice To Haves

• Associate degree is preferred.
• Two years of healthcare experience in an acute care setting is preferred.
• Knowledge of hospital protocols and procedures, clinical standards and outcomes, funding options, community resources and outside professional agencies, federal and state regulations governing hospital and home care, and the financial structure of a health plan and delivery system is preferred.

Responsibilities

• Outreach to and schedule patients due for annual wellness visits for all CVHP members.
• Act as a liaison between RN Case Managers, Medical Directors, patients, physicians, community resources, and other healthcare providers to ensure timely care coordination.
• Educate members and providers on annual wellness visit requirements and additional health care gaps identified by the CMS STARs scorecard.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED