Care Management LVN

About the role

The Care Management LVN serves as a clinical resource for Care Management review staff, providing guidance on procedures, standards, workflows, and program compliance. This role oversees daily case review workflows, auditing processes, ensures delivery of excellent customer service that aligns with organizational expectations, and manages a patient case load. The Care Management LVN evaluates patient needs, determines program eligibility, and develops care plans that promote optimal clinical outcomes, high-quality care, efficient resource utilization, and patient satisfaction.

Responsibilities

• Serve as a clinical resource for Care Management review staff, providing guidance on procedures, standards, workflows, and program compliance.
• Oversee daily case review workflows and auditing processes.
• Ensure delivery of excellent customer service aligned with organizational expectations.
• Manage a patient case load, evaluating patient needs and determining program eligibility.
• Develop care plans that promote optimal clinical outcomes, high-quality care, efficient resource utilization, and patient satisfaction.

Requirements

• High School diploma or equivalent (required).
• Graduate of an accredited Licensed Vocational Nursing program (required).
• Additional coursework in Case Management or Managed Care (preferred).
• 2+ years of inpatient or care management review experience in a managed care organization or healthcare facility (required).
• Experience in ambulatory case management and/or high-risk patient programs (preferred).

Qualifications

• Active, unrestricted California LVN License (required).
• Certified Case Manager (CCM) credential (preferred).

Skills

• Strong knowledge of healthcare delivery, case management principles, and managed care operations.
• Proficiency in Microsoft Office (Word, Excel, Outlook, Access, PowerPoint).
• Ability to type at least 40 WPM with accuracy.
• Excellent communication, interpersonal, and customer-service skills.
• Ability to prioritize, problem-solve, and work independently with minimal supervision.
• Skilled in documentation, time management, and maintaining compliance with regulations.
• Ability to collaborate across multidisciplinary clinical teams.

Physical, Mental & Environmental Requirements

The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job.

• Primarily sedentary role, with most time spent seated for computer work, documentation, and phone communication.
• Limited standing, walking, and occasional driving to clinical sites.
• May involve light physical tasks such as lifting up to 20 pounds, occasional bending, reaching, and climbing stairs.
• Requires strong analytical skills, attention to detail, emotional resilience when managing complex or high-risk cases, and the ability to multitask in a fast-paced environment.
• Work is performed mainly in a standard office setting with regular use of computers and office equipment, with occasional exposure to clinical environments such as hospitals, clinics, or skilled nursing facilities.

Pay

$35.00 - $40.00 / hourly