LVN Case Manager ECM

About The Company

JWCH Institute, Inc. Wesley Health Centers is a private non-profit health agency committed to improving the health status and well-being of under-served populations in the Los Angeles area. Our mission is to provide comprehensive and preventative health care programs and services, aiming to decrease health disparities and increase access to quality care.

Position Description

As an LVN Case Manager in our Enhanced Care Management (ECM) department, you will provide case management and healthcare services to diverse clients, including those experiencing homelessness, SMI, SUD, chronic medical conditions, and high utilizers of services. Your primary responsibilities include conducting assessments, developing care plans, and coordinating medical services. You will collaborate with interdisciplinary teams and facilitate access to medical resources, health education, and advocacy for client wellbeing.

Principal Responsibilities

• Collaborates with ECM Staff, Providers, Managed Care Plans, Housing Navigation Team, and community homeless service providers to offer enhanced care coordination for eligible patients and/or entities, ensuring a seamless experience for the patient and avoiding duplication of services.
• Conducts case management services, including intake and assessment (functional, psychosocial, housing, mental health, and substance use).
• Develops a comprehensive care plan based on the assessment with measurable goals, interventions, and objectives to effectively implement the care plan. Includes subspecialty referrals, regular monitoring of the care plan, and necessary follow-ups.
• Connects Members to other social services/support services and provides appropriate referrals for subspecialty care (e.g., ophthalmology, behavioral health, podiatry, nutrition), transportation, food, and housing.
• Accompanies members to office visits, as needed.
• Provides health education as needed based on the patient's requirements and follows up on compliance issues, especially with medication management, blood sugar, blood pressure, etc.
• Advocates on behalf of Members with healthcare professionals.
• Aid in the review of other LCM’s assessments and care plans to ensure they meet health plan requirements and community standards. All care plans to submitted to the health plan must be signed off by a licensed ECM staff in addition to the unlicensed care manager.
• Utilizes motivational interviewing, trauma-informed care, and harm-reduction approaches.
• Coordinates with hospital staff on discharge plans.
• Maintains treatment adherence, including medication.
• Provides health promotion and self-management training.
• Collects and enters necessary data for reporting purposes. Completes and submits monthly project activity and other reports as assigned for submission to the funding source.
• Participates in agency and community meetings related to the needs of patients and issues related to Case Management diseases.
• Attends weekly case conferences with PCP’s clinical supervisor and peers to assist in problem-solving related to clients and ensure the provision of professional guidance and high-quality case management services.
• Adhere to all organizational safety policies, procedures, and regulatory requirements to ensure a safe environment for patients, staff, and visitors.
• Identify, report, and help mitigate unsafe conditions, incidents, or hazards in the workplace.
• Uses equipment, tools, and supplies safely and responsibly in accordance with organizational and regulatory standards.
• Maintain awareness of infection control, occupational health, and emergency preparedness procedures appropriate to the role.
• Participate in JWCH’s customer service training called AIDET on an annual basis. Demonstrate an understanding of AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank You) to apply in patient encounters or team discussions. Utilize the AIDET communication framework to communicate with patients and team members in a manner that reduces patient anxiety, increases patient compliance, and improves clinical outcomes.
• Performs other duties as assigned.

Requirements

• LVN with at least 2 years of experience in case management and a current California license.
• Experience working with individuals who have multiple chronic conditions, frequent ER visits or in-patient admissions, mental illness, substance use disorders, or are experiencing homelessness.
• Electronic Health Record experience and data entry skills required. NextGen experience preferred.
• Proficient in utilizing Microsoft Word, Excel, and PowerPoint.
• Demonstrates excellent communication and customer service skills.
• Strong desire to work as part of a multi-disciplinary team with care coordinators, RNs, LCSWs, MSWs, PCPs, and MAs.
• Bilingual ability (English/Spanish) strongly preferred.
• Reliable transportation, a valid CA Driver’s License, and proof of insurance.
• BLS/First Aid training required.
• Ability to adapt to a dynamic and fast-paced healthcare environment.

Employee Benefits

• Competitive pay and a robust benefits package that includes:
• Medical, Dental, Vision
• Monthly employer-sponsored allowance for assistance with health premiums.
• Funded Health Savings Account (up to deductible) to assist with carrier-approved medical expenses.
• 401(k) Safe Harbor Profit Sharing plan.
• Mileage reimbursement.
• Short- and long-term disability plans (LTD/STD).
• Life insurance policy & AD&D, and more!