Supervisor, Long Term Care, LVN

Date: Nov 22, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8368 

 

Position Summary/Position

 

Under the direction of the Manager, Long Term Care (LTC), they will oversee the LTC clinical LVN and non-clinical Team Members and work with skilled nursing facilities and IPAs to ensure coordinated and continuous cost-effective quality healthcare for IEHP Members at both the skilled and custodial level of care.

Major Functions (Duties and Responsibilities)

 

1. Work closely with the LTC Manager to coordinate daily staffing and coverage of the LTC unit.
2. Responsible for the oversight of long term care case review and retrospective reviews for medical necessity, appropriateness of service and level of care for custodial, long term care.
3. Work closely with Clinical Team Leads and LTC Team Members to ensure authorizations for outpatient services or ancillary services are in place in preparation for the Member’s discharge or transition to lower level or higher level of care.
4. Responsible for ensuring that the concurrent or discharge review process includes referring Members to appropriate programs (e.g., Health Management, Health Education, Behavioral Health, Transitions of Care (TOC), Care Management, etc.), as needed.
5. Responsible for ensuring that the concurrent or retrospective review Team Members are referring cases that require physician review to the Medical Director in a timely manner.
5. Responsible for ensuring timely compliance and completion of documents as required by all regulatory agencies, such as, IFT Form.
6. Responsible for providing information and assistance to custodial LTC Team Members, other departments, IPAs, and the skilled nursing facilities to support the goals of the department and the vision of the organization.
7. Represent the LTC department in selected IEHP meetings.
8. Assist in the orientation of new custodial team members.
9. Assist in the collection and analyzing of data for monthly reports.
10. Conduct Team Member coaching/counseling corrective action meetings with the assistance of a Human Resource representative and the LTC Manager, up to and including termination.
11. Coach, evaluate and provide annual performance evaluation feedback to LVN and coordinator Team Members.

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Three (3) or more years of utilization management/case management in a health care delivery setting, with an emphasis on long term care and utilization management and one (1) year supervisory experience

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.

Knowledge Requirement

 

Responsible for the oversight of long term care case review and retrospective reviews for medical necessity and appropriateness of service and care. Knowledge of evidence based clinically criteria and CMS, NCQA, local and national coverage determinations.

Skills Requirement

 

Must have analytical skills. Excellent communication, interpersonal and organizational skills.

Abilities Requirement

 

Time management and problem-solving abilities. Must have a high degree of patience. Self-starter and a team player.

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.

A reasonable salary expectation is between $91,000.00 and $116,022.40, 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