LVN Case Manager - Bilingual

Job Summary

As a member of the interdisciplinary healthcare team, the Service Coordinator Level 2 provides care for non-HCBS waiver members. The main goals are to improve clinical and financial outcomes and ensure member satisfaction while managing the care plan.

The Service Coordinator Level 2 oversees the member's case within their licensure scope, supervises non-RN clinicians involved in the case according to state laws and contracts, and continuously develops, monitors, evaluates, and updates the care plan to meet the member's needs and optimize their healthcare.

Essential Duties And Responsibilities

• Conduct telephonic or face-to-face evaluations of members' needs and preferences, gathering relevant data from members and their families. Manage their physical health, behavioral health, social services, and long-term support needs.
• Educate and support members and their legal authorized representatives (LAR) on Consumer Directed or Service-Related delivery models.
• Perform initial and follow-up assessments and outreach calls within specified timeframes or upon request.
• Identify high-risk members and coordinate care with the healthcare team.
• Manage members with chronic illnesses, co-morbidities, and disabilities to ensure cost-effective and efficient use of health benefits.
• Assess, plan, and implement individualized care strategies aimed at the most appropriate, least restrictive level of care.
• Use company and community resources to create a safe and effective case management plan.
• Collaborate with members, families, and healthcare providers to develop individualized care plans.
• Initiate referrals for social service programs, including financial, psychosocial, community, and state services.
• Manage the care plan throughout the continuum of care as a single point of contact.
• Communicate health-related information to all stakeholders to ensure coordinated and timely care.
• Advocate for patients and families to ensure their needs and choices are supported by the healthcare team.
• Use approved clinical criteria to determine the appropriate level of care for members.
• Document all assessments, care plans, and referrals.
• Participate in interdisciplinary team meetings and utilization management rounds to assist with safe transitions of care.
• Understand insurance products, benefits, coverage limitations, and regulations as they apply to the health plan.
• Monitor service delivery to ensure timeliness, appropriateness, and member satisfaction.
• Report medically complex cases to appropriate roles for review and problem-solving.
• Maintain status on face-to-face and telephonic visit requirements for assigned members.
  
  

Knowledge And Skills

• Knowledge of specific case management processes, and person-centered care practice
• Excellent verbal and written communication skills
• Analytical decision making and judgment skills.
• Demonstrated ability to function as a clinical care team leader.
• Knowledgeable of all clinical resources available to patients both inpatient and outpatient
• Data Entry and Word Processing Skills
  
  

Required Qualifications

• Education minimum: Requires a minimum of LVN (Licensed vocational nurse), qualified IDD (Individuals with Developmental Disabilities) professional, or have an undergraduate or graduate degree in social work or a related field. Registered Nurse(preferred), Nurse Practitioner, Licensed Social Worker, Physician Assistant in Texas
• 2 years of experience working within the community health setting in a health care role.
• 2 years of experience working in a community health, clinical, hospital, acute care, direct care or case management setting.
• 2 years of experience working with MS Word, Excel, and Outlook
• Ability to travel in assigned region to visit Medicaid members in their homes and / or other settings, including community centers, hospitals etc.
• Reliable transportation with valid driver’s license with a good driving record
• Bilingual – Spanish (fluent is required)
  
  

Preferred Qualifications

• Bachelor’s Degree
• Experience with electronic charting
• Experience with arranging community resources.
• Field-based work experience
• 2 years of experience working with Medicaid Waiver populations.
• Behavioral Health Experience
• Background in managing populations with complex medical or behavioral needs.
  
  

Benefits

At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:

• Competitive pay & weekly paychecks
• Health, dental, vision, and life insurance
• 401(k) savings plan
• Awards and recognition programs
• Benefit eligibility is dependent on employment status.
  
  

About Amergis

Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions.

Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.