Licensed Vocational Nurse

Rancho Health MSO, Inc • Temecula, CA

15d • Remote

About The Position

The Licensed Vocational Nurse (LVN) – Care Management plays a key role in supporting patient-centered care coordination across the continuum. This position assists in proactive outreach, chronic disease management, transitional care follow-up, patient education, and closing care gaps. The LVN collaborates closely with Registered Nurses, providers, care coordinators, and other healthcare disciplines to promote quality outcomes, patient satisfaction, and cost-effective care.

Requirements

• Active California LVN License in good standing (or state required)
• Current BLS/CPR Certification
• Minimum 1 year of clinical experience in outpatient, care management, home health, or related setting
• Strong telephonic communication skills with the ability to build rapport and motivate patients
• Proficient in EMR documentation and basic computer systems

Nice To Haves

• Experience in Chronic Care Management (CCM), Population Health, ACO programs, or Case Management
• Knowledge of CMS quality programs and healthcare payer requirements
• Bilingual in English/Spanish

Responsibilities

• Conduct structured outreach calls to patients enrolled in care management programs (e.g., Chronic Care Management—CCM, Transitional Care, Complex Care, High-Risk Programs).
• Perform timely post-discharge follow-ups to ensure medication adherence, appointment scheduling, symptom review, and identification of barriers to care.
• Assist in development and documentation of patient-centered care plans based on goals, risk factors, and provider direction.
• Monitor and support patients with chronic conditions through education and self-management reinforcement.
• Identify and escalate clinical concerns or red-flag symptoms to RN or provider promptly.
• Maintain accurate, detailed documentation in the electronic medical record (EMR), ensuring compliance with CMS, payer, and organizational standards.
• Review and close care gaps including labs, preventive care, and specialty follow-up.
• Coordinate services such as DME, Home Health, or Community Resource referrals as directed by RN or provider.
• Support population health initiatives related to quality metrics, risk adjustment, and value-based care.
• Participate in interdisciplinary huddles, case conferences, and workflow improvement initiatives.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed