Case Manager (LVN or RN)

Astrana Health

Monterey Park (CA)

Hybrid

USD 42,705 - 61,992

Full time

14 days+

Get more replies from employers

Send a job-specific resume in minutes.

Job summary

A health care organization in Monterey Park is seeking a Case Manager (LVN or RN) to manage patient care effectively. This role involves working collaboratively with medical teams to establish discharge plans and ensure compliance with health standards. Candidates need an active California RN or LVN license and at least two years of clinical experience. The position offers a hybrid work structure with competitive pay ranging from $31.00 to $45.00 per hour.

Qualifications

Active Registered Nurse (RN) license in California OR active Licensed Vocational Nurse (LVN) license in California.
Experience using Microsoft applications such as Word, Excel and Outlook.
At least two (2) years of clinical experience as an RN/LVN.

Responsibilities

Comply with Case Management Department policies and procedures.
Utilize Milliman Care Guidelines for patient transition.
Collaborate with Hospitalists and discharge planners on discharge plans.
Coordinate reviews based on medical records and report to management.
Maintain relationships with health plans and resolve issues.

Skills

Analytical critical reasoning

Prioritizing multiple responsibilities

Educating and training staff

Communication skills

Customer service skills

Education

Active RN or LVN license in California

At least two years of clinical experience

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

EZCAP

Job description

Join to apply for the Case Manager (LVN or RN) role at Astrana Health

Location: 1600 Corporate Center Dr., Monterey Park, CA 91754

Compensation: $31.00 - $45.00 / hour

Department: HS - ICM

Astrana is looking for a RN/LVN Case Manager and we are willing to train a RN or LVN with no case management experience! You will have the ability to work with pediatrics and/or adult populations depending on business need.

Our Values

Put Patients First
Empower Entrepreneurial Provider and Care Teams
Operate with Integrity & Excellence
Be Innovative
Work As One Team

What You'll Do

Comply with Case Management Department’s policies and procedures
95 - 100% compliance with Utilization Management health plan delegation standards for Case Management
Utilize Milliman Care Guidelines criteria for appropriateness of transition to care by level of skilled needs and acute rehab for post discharge plan
Collaborating with Hospitalists, case managers, and discharge planners to establish discharge plans at time of admission
Responsible for coordinating the required initial and concurrent reviews based on the review of medical records received and daily accurate reporting of all inpatient admissions to Medical Director and Manager and/or Supervisor of Case Management Department
Review of medical records and/or other documentation to determine medical necessity, appropriateness and level of care utilizing Milliman Care and other appropriate Guidelines
Assess, plan, implement, coordinate, monitor, and evaluate all options and services with the goal of reducing hospital readmission • Attends/coordinates Case Management meetings on and off‑site as necessary
Interacts with the providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirements
Attend to provider and interdepartmental calls in accordance with exceptional customer service
Maintain good relationships with health plans, hospitals and medical directors. Resolve problems that arise with any IPA medical directors
Report to Manager and/or Supervisor of Case Management on activities and/or problems occurring throughout the day
Available for Hospital on site Case Management
Other duties as assigned

Qualifications

Active Registered Nurse (RN) license in California OR active Licensed Vocational Nurse (LVN) license in California
Experience using Microsoft applications such as Word, Excel and Outlook
At least two (2) years of clinical experience as an RN/LVN

You're great for this role if:

Excellent analytical critical reasoning
Proven ability to prioritize multiple responsibilities simultaneously in a fast‑paced, changing environment while meeting deadlines
Ability to educate and train staff members and other departments as needed
Experience using EZCAP
Strong communication and customer service skills

Environmental Job Requirements and Working Conditions

Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The position is located at 1600 Corporate Center Dr, Monterey Park, CA 91754.
This role will require visiting patients in our partnered hospitals.
The target pay range for this role is between $31.00 - $45.00 (LVN - $31.00-38.00; RN - $39.00-45.00) per hour. The salary range represents our national target range for this role.

Astrana Health is proud to be an Equal Employment Opportunity and affirmative action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Seniority level