Pediatrics Care Manager LVN/LPN Hybrid in Orange County
About The Position
Provides support for care management and care coordination activities, collaborating with a multidisciplinary team to coordinate integrated member care across the continuum. Works to help members progress toward desired outcomes and contributes to the strategy of providing quality, cost-effective care. The role includes assessing members, identifying potential care-management needs, developing and monitoring care plans, maintaining a member caseload, and coordinating services and resources. Contacts may be conducted by phone, face-to-face, or home visits. An estimated 25–40% local travel may be required, depending on state and contractual requirements.
Requirements
- At least 2 years of health care experience, preferably in care management or a medical and/or behavioral health setting, or an equivalent combination of relevant education and experience.
- Clinical licensure and/or certification when required by state contract, regulation, business operating model, or state board licensing mandates.
- Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel, unless otherwise required by law.
- Demonstrated knowledge of community resources.
- Ability to work proactively and with attention to detail.
- Ability to work in varied settings and adjust approach when working with diverse populations, personalities, and personal situations.
- Ability to work independently with minimal supervision and demonstrate self-motivation.
- Responsiveness in all forms of communication and ability to remain calm in high-pressure situations.
- Ability to develop and maintain professional relationships.
- Excellent time-management and prioritization skills, ability to manage multiple projects simultaneously, and adaptability to change.
- Excellent problem-solving and critical-thinking skills.
- Strong verbal and written communication skills.
- Proficiency with Microsoft Office and applicable software programs.
- A bachelor's degree in a health care-related field may be required in some states, depending on state or contractual requirements.
Responsibilities
- Complete member assessments within regulated timelines and determine potential eligibility for care coordination or care management based on assessment triggers.
- Develop and implement care plans with members, caregivers, physicians, other appropriate health care professionals, and member support networks.
- Conduct telephonic, face-to-face, or home visits as required.
- Monitor care plans, evaluate effectiveness, document interventions and goal achievement, and suggest changes as appropriate.
- Maintain an ongoing member caseload for regular outreach and management.
- Promote integration of behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
- Facilitate interdisciplinary care team (ICT) meetings and informal ICT collaboration.
- Use motivational interviewing and Molina clinical guideposts to educate, support, and motivate members during contacts.
- Assess barriers to care and provide care coordination and assistance to address member concerns.
- Collaborate with licensed care managers and leadership as needed or required.
- Travel locally an estimated 25–40% when required by state or contractual requirements.
Benefits
- Competitive benefits and compensation package.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
