LVN Nurse Discharge Planner - CalAIM

About the role

Make a difference every day in the lives of the underserved by joining a mission‑driven organization with a people‑first culture that offers excellent career growth opportunities. Find a career that supports caring for overlooked, underserved, and vulnerable patients, enjoying autonomy in a warm team environment with ongoing growth and training. The Nurse Discharge Planner LVN develops and coordinates clinically informed reentry care plans for CalAIM‑eligible individuals to address medical, behavioral health, and substance use needs prior to release. The role conducts basic nursing assessments, reviews health records, coordinates referrals, and facilitates warm handoffs to managed care plans and community providers. It ensures timely service delivery by documenting services in the EHR, tracking release timelines, activating Justice‑Involved aid codes, and collaborating with in‑reach partners and Medi‑Cal eligibility staff.

Responsibilities

• Provide discharge planning services for medical, mental health, MAT, and related programs in accordance with contract requirements and policies.
• Identify release‑planning needs, coordinate medications and medical needs upon release, and arrange referrals and appointments with community providers.
• Facilitate psychoeducational sessions, benefit applications, and resumption of services to support continuity of care.
• Maintain working relationships with facility staff, parole, mental health, and medical partners while adhering to security regulations.
• Document services in the health record, activate Justice‑Involved aid codes, and ensure compliance with DHCS CalAIM requirements.

Qualifications

• Education: Graduation from an accredited School of Nursing is required. A Bachelor's degree in Social Work, Business Administration, or other health‑related fields from an accredited college or university is preferred.
• Experience: Previous experience in developing successful transition plans involving community resources for persons with medical, substance use, and/or mental illness is preferred.
• Licenses/Certifications: Current licensure as a Licensed Practical/Licensed Vocational Nurse within the state of employment; must maintain CPR certification and any other certifications (such as First Aid) required by contract; must be able to attain and maintain security clearance to the facility.
• Additional: Position is available only to those who reside in the United States.

Benefits

• Comprehensive benefits including medical, dental, vision, paid time off, and 401(k).
• DailyPay – receive your money as you earn it.
• Tuition assistance and dependent scholarships.
• Employee Assistance Program (EAP) including free counseling and health coaching.
• Company‑paid life insurance.
• Tax‑free Health Spending Accounts (HSA).
• Wellness program featuring fitness memberships and product discounts.
• Preferred banking partnership and discounted rates for home and auto loans.

Pay

Pay range: $40.50 - $45.00

Schedule

Schedule: Mon‑Fri 8:00 am‑4:30 pm, with alternating weekends required.