Care Manager, LVN (Hybrid Work Shift)

Date: Nov 23, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8187 

 

Position Summary/Position


Under the general direction of the department leadership, the Care Manager, LVN is responsible for working directly with the Plan, IPA medical groups, providers, hospitals, community agencies, Members/caregivers, and other entities supporting Member care to ensure coordinated care and serve as a resource person for internal and external entities. The Care Manager, LVN works closely with the RN Care Manager and other members in the care team to support the member in the care management process.

Major Functions (Duties and Responsibilities)


1. Responsible for serving as a resource for IEHP Members and Providers for care management and care coordination.
2. Responsible for screening Members for appropriate care management needs, documenting findings and communicating the findings to the RN Care Manager.
    a.Care Manager, LVN uses approved screening tools which contribute to the assessment (i.e. Health Risk Assessment or other designed tool)
3. Contributing to the development and modification of the Individualized Care Plan (ICP) including: 
      a. Reviewing ICP recommendations with RN Care Manager Team Member and other Interdisciplinary Care Team (ICT) members as appropriate
      b. Educating Members according to approved plan and material content
    c. Communicating unexpected results with RN Care Manager Team Member and other ICT members as appropriate.
4. Acts as a Member advocate at all times
5. Serves as a liaison between Members, caregivers, and all members of the ICT
6. Assist and facilitate referrals for IEHP Members that are eligible for carve-out programs such as CCS, multi-organ transplant, etc.
7. Assist members with immediate needs with regard to access, referrals and authorizations.
8. Facilitates referrals to resources such as LTSS, Independent Living and Diversity Services, Behavioral Health, and community resources.
9. Model the highest ethical behavior in relationships with co-workers, supervisors, Members, Providers, and colleagues in the community.
10. Responsible for promoting a collaborative and effective working environment within the Team by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions.
11. Responsible for building and maintaining a positive working relationship with Providers, including, but not limited to, communication via in-person, over the phone, and through digital means such as email and fax.
12. Responsible for engaging with Members, both in-person and on the phone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the Member and his or her medical/behavioral team, as well as to increase the Member’s sense of control over their whole health.
13. Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as by identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving Member health outcomes.
14. Assists with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services.
15. Responsible for any other duties as required to ensure successful care management processes and Member outcomes.       
16. Under the direction of designated supervisor or request from a licensed Team Member (i.e. RN Care Manager), other duties as required to ensure Health Plan operations are successful.

Experience Qualifications


Three (3) or more years of care management experience in a health care delivery setting. 

Current IEHP Team Members who have worked at least two (2) years in the Care Management department, and are successful in their current work performance during that time, may be considered for this position in lieu of the minimum one (1) year clinical experience requirement.

Preferred Experience

 

Experience in an HMO or experience in Managed Care setting preferred. Minimum one (1) year clinical experience in and acute care facility, skilled nursing facility, home health or clinic setting preferred.

Education Qualifications

 

High school diploma or GED required.

Professional Licenses

 

Possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required.

Drivers License Required

Yes, must have a valid California Driver's License.

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to twenty-five (25) pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership.

A reasonable salary expectation is between $61,422.40 and $78,312.00, based upon experience and internal equity.

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles