Care Manager, LVN Short-Term Assignment

Inland Empire Health Plan; California (MO); Hybrid; USD 64,000 - 83,000; Full time

Job summary

Inland Empire Health Plan (IEHP) is seeking a Care Manager, LVN for a short-term assignment in a hybrid role serving IEHP members across the network. You will work with the multidisciplinary care team to coordinate care, educate members, and support ICP development and implementation.

The position requires an active CA LVN license and several years in care management within an HMO or similar setting. Telecommute options are available with periodic on-site meetings at Rancho Cucamonga, CA, to

Qualifications

• Three (3) or more years of care management experience in a health care delivery setting required.
• Experience in an HMO or Managed Care setting preferred; at least 1 year clinical experience in acute care, SNF, home health, or clinic setting preferred.
• High school diploma or GED required; Associate’s degree preferred; LVN license required in California.
• California Driver’s License preferred.

Responsibilities

• Serve as a resource for IEHP members and providers for care management and care coordination.
• Screen members for appropriate care management needs and document findings using approved tools.
• Develop and modify the Individualized Care Plan (ICP) with the care team; educate members per plan and materials.
• Assist with access, referrals, and authorizations; advocate for members with PCPs, specialists, and ancillary services.
• Model ethical behavior and foster collaboration with providers and community colleagues.
• Engage with members using Motivational Interviewing to promote joint decision making and health outcomes.
• Participate in quality improvement initiatives and address HEDIS gaps.

Skills

Care management

HMO/Managed Care understanding

Communication skills

Data interpretation

Confidentiality

Detail-oriented

Education

High school diploma or GED

Associate’s degree preferred

LVN license (CA) active

California Driver’s License preferred

Tools

MS Office Suite

Job description

Overview

This position is a Short-term Assignment with IEHP.

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to anauthentic experience!

Under the general direction of department leadership, the Care Manager, LVN is responsible for working directly with the IEHP members, IPA medical groups, providers, hospitals, community agencies, and other entities supporting member care to ensure coordinated care and serve as a resource person for internal and external entities. The Care Manager, LVN works closely with the multidisciplinary care team to support members during the care coordination and care management process.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Key Responsibilities

• Serve as a resource for IEHP members and providers for care management and care coordination.
• Screen members for appropriate care management needs, documenting findings and communicating with the rest of the care team. Use approved screening tools which contribute to the assessment (i.e., Health Risk Assessment or other designed tools).
• Contribute to the development and modification of the Individualized Care Plan (ICP) including:
  • Review ICP recommendations with RN Care Manager Team Member and other Interdisciplinary Care Team (ICT) members as appropriate.
  • Educate members according to approved plan and material content.
  • Communicate unexpected results with RN Care Manager Team Member and other ICT members as appropriate.
• Assist members with immediate needs with regard to access, referrals and authorizations. Act as a member advocate at all times. Assist with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services.
• Model the highest ethical behavior in relationships with co-workers, supervisors, members, providers, and colleagues in the community.
• Build and maintain a positive working relationship with providers, community agencies, and internal colleagues through all modes of communication (e.g., communication via in-person, over the phone, and through digital means such as email and fax). Promote a collaborative and effective working environment within the Team by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on member case discussions.
• Engage with members, both in-person and on the phone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the member and his or her medical/behavioral team, as well to increase the member’s sense of control over their whole health.
• Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as by identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving member health outcomes.
• Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Qualifications

Education & Requirements

• Three (3) or more years of care management experience in a health care delivery setting required
  • Current IEHP Team Members who have worked at least two (2) years in the Care Management department and are currently successful in their work performance during the last two (2) years, may be considered for this position in lieu of the minimum three (3) year experience requirement
• Experience in an HMO or experience in Managed Care setting preferred. Minimum one (1) year clinical experience in and acute care facility, skilled nursing facility, home health or clinic setting preferred
• High school diploma or GED required
• Associate’s degree from an accredited institution preferred
• Possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required
• Valid California Driver’s License preferred

Key Qualifications

• Working knowledge of health care delivery systems
• Working knowledge of PC applications including MS Office Suite and other supportive technology. Written and oral communication skills
• Proven ability to:
  • Read and interpret data
  • Analyze problems and formulate appropriate plans, solutions, and courses of action
  • Establish and maintain cooperative working relationships with individuals at all levels of the organization and members
  • Maintain confidentiality of members and all related entity business matters of the organization
  • Be detail oriented

Work Model Location

Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.)

Pay Range

USD $63,897.60 - USD $83,075.20 /Yr.