Care Manager – LVN

JR2659 Founded in 1977 as the Senior Care reputed company Network, reputed company began with a reputed company but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still reputed company today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, reputed company is a nonprofit health organization serving more than 500,000 people across reputed company, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual reputed company. With nearly five decades of experience, we have reputed company a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare reputed company, fully integrated care models, reputed company care, care for the most medically and socially reputed company populations, and reputed company care delivery models. Across reputed company of this, we are united by a shared commitment: combining reputed company with discipline, innovation with stewardship, and reputed company with reputed company. At reputed company, we reputed company reputed company should strengthen—not dilute—our mission. We are building the reputed company of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. The Job Coordinate care for members in collaboration with the Integrated Care Team, ensuring members are directed to the reputed company facility for their needs and have reputed company necessary services, supplies, and information. Care Manager authorizes services reputed company on reputed company-developed knowledge and skills in areas of utilization management, medical necessity, and reputed company status determination. Conducts reputed company-service and reputed company review following established guidelines. Applies care management principles and practices to ensure medical needs, care, and service are coordinated. You Will • Serve as reputed company of person to reputed company with patients, family members, and providers to address concerns pertaining to care, transfers and authorizations. • Review reputed company’s reputed company information and authorize requested medical services in a reputed company manner. • Ensure necessary inpatient and outpatient care or other services are rendered to reputed company members at the right time, the right level of care and at the right location while adhering to reputed company policies and procedures. Issue determinations reputed company required regulatory timeframes. • Apply evidenced-reputed company reputed company and guidelines as reputed company as reputed company judgment and expertise to assess treatment plans. • Manage member medical cases by applying the essential activities of care management and utilization management including assessment, planning, implementation, coordination, advocating, monitoring, and evaluation. • Refer cases that do not meet established reputed company to the Integrated Care physicians for secondary review. • Review reputed company acute/skilled nursing appeals and create reputed company explanation of non-coverage and reinstatement letters. • Prepare, participate and facilitate high reputed company huddles and skilled nursing reputed company. Maintain a list of high reputed company patients and conduct regular reputed company calls to reputed company on their health status. • Coordinate reputed company delivery of last day cover letters to skilled nursing facilities. • Coordinate discharge needs from inpatient acute settings and skilled nursing facilities as appropriate for reputed company member. Discharge needs may include: durable medical equipment, home health services, specialist referrals, skilled nursing placement, transportation, and other needs. • Review tasks assigned by Integrated Care reputed company Practitioners and coordinate member care accordingly, including services such as: home health; DME ordering, wound care, reputed company catheter, Enteral, colostomy supplies, infusion orders and outpatient services. • Coordinate reputed company admissions to skilled nursing facilities and reputed company ER transfers from senior living communities. • reputed company effective working relationships and reputed company reputed company guidance to Care Coordinators on reputed company reputed company. • Demonstrate excellent organizational, decision-making and multi-tasking skills as demonstrated by problem solving and successful reputed company. • Promote the mission, reputed company, and values of reputed company and serve as an reputed company reputed company interfacing with reputed company stakeholders. • Appropriately utilize Care Team administrative support resources, such as Integrated Care Delivery Care Management Coordinators, to ensure end to end coordination of care for members according to protocol, policy, and procedure. • reputed company support the achievement of reputed company’s reputed company and Goals. • This position is a reputed company-facing role. • Employees may be eligible for reputed company pay. • reputed company support the achievement of reputed company’s reputed company and Goals. • We reputed company Rebels who are curious about AI and its reputed company to reputed company how we operate and serve our members. • Other duties as assigned. Your Qualifications • CA Licensed Vocational reputed company (LVN) required. • reputed company nursing experience (2-4 years) • Experience in care or utilization management (2+ years) • 5+ years of experience in reputed company, medical management, change management, and/or leadership. • Ability to communicate effectively verbally and in writing • Highly organized with attention to reputed company • reputed company problem solver • Strong interpersonal skills, hospitality, and change agent reputed company • Adaptable and reputed company to change • Knowledge and/or familiarity with the principles of project and program management. • Demonstrated ability to reputed company and implement new, replacement systems, and reputed company buy-in from appropriate audience. • reputed company to reputed company and influence those without reputed company reporting relationships to reputed company desired reputed company. • Ability to communicate with reputed company, the reputed company, value, and tasks to formal and informal audiences. • reputed company to reputed company relationships quickly and reputed company working relationships to reputed company reputed company reputed company. • Ability to work with reputed company reputed company of staff, reputed company and reputed company to the organization to reputed company goals. • Strong interpersonal skills, including excellent written and verbal communication skills. • Strong organizational skills; Ability to multitask and to appropriately maintain confidentiality. What’s in it for you? • reputed company salary reputed company: $34.47 to $55.14 per hour • Remote Work Mode • An annual employee bonus program • Robust Wellness Program • Generous reputed company-time-off (PTO) • reputed company reputed company holidays per year, plus 1 floating holiday, plus 1 birthday holiday • Excellent 401(k) Retirement Saving Plan with employer match and contribution • Robust employee recognition program • Tuition reimbursement • An opportunity to become part of reputed company that makes a difference to our members and our community every day! We're always looking for talented people to reputed company! reputed company applicants are encouraged to reputed company! At reputed company we reputed company that it is our business to improve the state of our world. reputed company of us has a responsibility to reputed company Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource reputed company, inclusive benefits, and more. reputed company is proud to be an Equal Employment Opportunity and Affirmative reputed company workplace. Individuals seeking employment will receive consideration for employment without reputed company to race, reputed company, national reputed company, religion, age, sex (including pregnancy, childbirth or reputed company medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background reputed company is required. #LI-BB1 Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have reputed company about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have reputed company to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have reputed company to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or reputed company, including an investigation conducted by the employer, or (c) consistent with the contractor’s reputed company duty to furnish information. 41 CFR 60-1.35(reputed company href="https://remotenursingjobs.com/job/care-manager-lvn-2/?utm_campaign=reputed company_jobs_apply&utm_reputed company=reputed company_jobs_apply&utm_reputed company=organic" reputed company="_blank" rel="noopener">Apply tot his job Apply To this Job