Health Plan Case Manager LVN

Trinity Health • Fresno, CA

3d

About The Position

Reporting to the Director CVHP Operations, this position is responsible for outreach and scheduling for CVHP members due for annual wellness visits. The Health Plan Case Manager LVN acts as a liaison between RN Case Managers, Medical Directors, patients, physicians, community resources, and other healthcare providers to support timely care coordination. The position also educates members and providers on annual wellness visit requirements and additional healthcare gaps identified for each member by the CMS STARs scorecard.

Requirements

• High school diploma or equivalent.
• Graduation from an accredited Licensed Vocational Nurse (LVN) program.
• Current licensure as a Licensed Vocational Nurse (LVN) in California.
• Current American Heart Association (AHA) Healthcare Provider CPR card.
• Excellent communication, critical-thinking, creative problem-solving, organizational, and planning skills.
• Ability to work independently under pressure, balance changing priorities, meet deadlines, and manage frequent interruptions and a demanding workload in a diverse environment.
• Ability to set and organize work priorities and adapt as priorities change.
• Familiarity with standard desktop and Windows-based computer systems, including email, e-learning, intranet, and computer navigation.
• Additional time commitment may be required to complete work responsibilities.

Nice To Haves

• Associate degree.
• Two years of healthcare experience in an acute care setting.
• 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 health plans and delivery systems.

Responsibilities

• Outreach to CVHP members due for annual wellness visits and schedule their visits.
• Liaise between RN Case Managers, Medical Directors, patients, physicians, community resources, and other healthcare providers to coordinate timely care.
• Educate members and providers about annual wellness visit requirements and additional healthcare gaps identified by the CMS STARs scorecard.

What This Job Offers

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