Health Plan Case Manager LVN
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At a glance
Requirements
Credentials this posting asks for.
Job overview
Trinity Health is hiring a Health Plan Case Manager LVN. The Health Plan Case Manager LVN reports to the Director CVHP Operations and coordinates annual wellness visits for CVHP members, acting as a liaison among RN case managers, medical directors, patients, physicians, and community resources to ensure timely care and educate on visit requirements and CMS STARs gaps.
Key focus areas include Outreach and schedule patients due for annual wellness visits, Act as liaison between RN case managers, medical directors, patients, physicians, and community resources to ensure timely care coordination, and Educate members and providers on annual wellness visit requirements and CMS STARs health care gaps.
Important skills include Communication, Problem Solving, Creative Problem Solving, Organizational Planning, Self-Directed, and Ability To Work Under Pressure. Preferred (not required): Hospital Protocol Knowledge, Clinical Standards Knowledge, Funding Options Knowledge, and Community Resources Knowledge.
Skills & qualifications
Skills
Qualifications
Full job description
Employment Type: Full time Shift:
Description: SUMMARY
Reporting to the Director CVHP Operations, CVHP Operations, this position is responsible for outreaching & scheduling patients due for annual wellness visits for all CVHP members. This position will act 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 will ensure that members and providers are educated on the 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. Associates degree is preferred.
- Graduate of an accredited Licensed Vocational Nurse (LVN) program is required.
- Current licensure as a Licensed Vocational Nurse (LVN) in the state of California is required.
- Current American Heart Association (AHA) Healthcare Provider CPR card is required.
- Two (2) years of healthcare experience in an acute care setting is preferred.
- Excellent communication skills, critical thinking, creative problem-solving skills, and competent organizational and planning skills are required.
- Self-directed with the ability to work under pressure and balance evolving priorities while meeting deadlines in a diverse environment with frequent interruptions and a demanding workload is required. Must possess the ability to set and organize own work priorities and adapt to them as they change frequently. Additional time commitment may be required to complete work responsibilities.
- Familiarity with standard desktop and windows-based computer systems, including email, e-learning, intranet, and computer navigation is required.
- Knowledge regarding hospital protocol and procedures, clinical standards and outcomes, funding options, familiarity with community resources and outside professional agencies, familiarity with federal and state regulations governing hospital and home care, as well as understanding of the financial structure of health plan and delivery system is preferred.
Pay Range $29.25 - $40.95
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
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