LICENSED VOCATIONAL NURSE-LCM

About the role

The Lead Care Manager (LVN) works in collaboration and continuous partnership with chronically ill or “high-risk” members and their family/caregiver(s), clinic/hospital/specialty providers and staff, and community resources in a team approach to ensure comprehensive care coordination and support.

Responsibilities

• Coordinate with members, family/caregiver(s), providers, and community resources to ensure a seamless experience and non-duplication of services.
• Engage eligible members and oversee the provision of Enhanced Care Management (ECM) services and implementation of the care plan.
• Offer services where the member lives, seeks care, or finds most easily accessible, within Plan guidelines.
• Connect members to social services and supports, including transportation.
• Advocate on behalf of members with healthcare professionals using motivational interviewing, trauma-informed care, and harm-reduction approaches.
• Coordinate with hospital staff on discharge plans and accompany members to office visits as needed.
• Monitor treatment adherence, including medication, and provide health promotion and self-management training.
• Promote timely access to appropriate care, increase utilization of preventative care, and reduce emergency room utilization and hospital readmissions.
• Provide culturally and linguistically appropriate education to increase member comprehension.
• Create and promote adherence to a care plan developed in coordination with the member, primary care provider, and family/caregiver(s).
• Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals.
• Enhance members’ ability for self-management and shared decision-making.
• Connect members to relevant community resources to improve health and well-being, increase satisfaction, and reduce healthcare costs.
• Serve as the contact point, advocate, and informational resource for members, care team, family/caregiver(s), payers, and community resources.
• Assess members’ unmet health and social needs and develop a care plan with the member, family/caregiver(s), and providers.
• Monitor adherence to care plans, evaluate effectiveness, and facilitate changes as needed.
• Create ongoing processes for members and family/caregiver(s) to determine and request care coordination support.
• Facilitate member access to appropriate medical and specialty providers.
• Educate members and family/caregiver(s) about relevant community resources.
• Facilitate and attend meetings between members, family/caregiver(s), care team, payers, and community resources as needed.
• Support primary care and specialty provider co-management with timely communication and follow-up.
• Assist with the identification of “high-risk” members and add them to the member registry or flag in EHR.
• Attend all Lead Care Manager training courses, webinars, and meetings.
• Provide feedback for the improvement of the ECM Program.
• Arrange transportation and facilitate member visits with the ECM Lead Care Manager.
• Consistently achieve a minimum daily expectation of 30 schedules/day.

Requirements

• Must be able to perform each essential duty satisfactorily; reasonable accommodations may be made for individuals with disabilities.
• Required to have and maintain a personal vehicle for this role, with a valid driver’s license, proof of insurance, and a good driving record.
• Must visit hospitals and patients at their homes as needed.
• Must present proof of negative TB test and CPR certification before the hire date.
• Must complete a Live Scan fingerprint/background check.

Qualifications

• An associate’s degree or bachelor's degree in health science or a related healthcare field is preferred.
• Social Worker, LVN, or experience in case management is a plus.

Skills

• Excellent analytical, problem-solving, and prioritization skills.
• Excellent verbal and written communication skills.
• High-level interpersonal skills; able to work collaboratively with multidisciplinary and diverse teams.
• Effective computer skills, particularly Microsoft Office (Excel, PowerPoint, Word).
• Ability to work independently to complete assigned tasks.
• Experience with team building, project management, change management, and quality/process improvement tools.

Benefits

• Medical, dental, and vision benefits available after successful completion of a 90-day probationary period.
• Free $100K life insurance.
• 401k eligibility after 1,000 hours of service.

Pay

Starting hourly range for this role is $30-$32 per hour.