What are the responsibilities and job description for the ACM Case Manager LVN (Temp) position at Astrana Health?
Description
What You'll Do
Qualifications
Environmental Job Requirements and Working Conditions
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Provide efficient and effective Care Management to qualified members by addressing the member’s medical, physical and psychosocial needs. Using clinical judgement develops, modifies and assists the member to implement their care plan. Ensure all tasks are compliant with Model of Care and Training.
Our Values:
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Assess identified members in a timely fashion to ensure appropriate assessment and individualized care plans are developed with the member according to the requirements in the Model of Care and training.
- Based upon care management criteria, contact and completes assessments for members identified as potential candidates for care management.
- Evaluates assessment findings against evidenced-based guidelines to develop a plan of care based on member needs and findings with collaboration from the interdisciplinary team.
- Identifies potential barriers to adherence to treatment plan and modifies plan by mutual agreement with the member.
- Educates member/caregiver on specific disease using approved evidence-based guideline and; using clinical judgement, modifies plan of care/goals based on member’s readiness to change.
- Facilitates care coordination across the care continuum (home, hospital, home health), identifies community resources and makes referrals as appropriate.
- Contact members after hospital discharge to perform assessment and complete medication reconciliation. Provide education, coordination of care, and follow up to prevent readmission.
- Encourage members to take an active role in both chronic disease and health prevention utilizing self-management support and patient education.
- Discuss self-management goals with the patient and assists them in selecting appropriate goals.
- Assesses cultural and linguistic needs and preference
- Consistently documents activities and interventions provided to the member according to the training.
- Attends/participates in interdisciplinary team meetings.
- Provides enrollee with support telephonically
- Be available to participate in on-call schedule.
- Attends/participates in staff meetings
- Participates in all health plan audit and preparation as applicable.
- Participates in all health plan seminars and training as applicable.
- Develop a working relation with internal departments to maintain the flow of needed information.
- Submit reports of productivity as applicable.
- Maintains the member’s right to privacy and protects Astrana Health operations by keeping information confidential.
Qualifications
Required:
- Current and active California license, LVN.
- Experienced in managed care environment to include but not limited to health plan, IPA or MSO.
- Experience with clinical issues, clinical guidelines, case management, & managed care.
- Excellent analytical critical reasoning and interpersonal communication skill.
- Excellent written and oral communication skills, as well as strong interpersonal, critical thinking and analytical skills.
- Excellent organizational, decision-making and multi-tasking skills.
- Must be able to work autonomously utilizing all resources available while staying within the boundaries of duties but also as a team member.
- Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information is required.
- Proficient with Microsoft Office (Word, Excel, Power Point)
Preferred:
- Bilingual - fluent in Chinese (Cantonese and/or Mandarin)
- 1 years of Case Manager experience
- Basic knowledge of ICE, DHS, DMHC, NCQA, and CMS standards
- Previous experience of Case Management including BCM, CCM, SNP, ECM
Environmental Job Requirements and Working Conditions
- Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office locations is 1600 Corporate Center Dr., Monterey Park, CA 91754.
- The total pay range for this role is: $30 - $40 per hour. This salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Salary : $30 - $40
