LVN/LPN Care Coordinator & Transition Specialist

Kaiser Permanente; San Diego (CA); On-site; USD 65,000 - 95,000; Full time

Job summary

Kaiser Permanente in California seeks a LVN/LPN Case Manager Assistant to conduct medical necessity screening and coordinate care under the direction of a Registered Nurse and the interdisciplinary team.

You will manage transition plans with RN/SW input, document in electronic systems, and ensure compliance with CMS and Kaiser policies while advocating for patients and coordinating with payers and care teams.

Qualifications

• Two years of hospital, ambulatory, or post-acute experience.
• LVN/LPN license in California.
• Ability to conduct medical necessity screening and coordinate care with RN/SW.
• Familiarity with InterQual and Utilization Management practices.

Responsibilities

• Accurate medical necessity screening and submission for Physician Advisor review.
• Care coordination and transition planning based on RN Case Manager and SW assessments.
• Documentation in the Case Management system with complete patient data.
• Identify and report potentially avoidable days and variances in resource use.
• Coordinate with physicians, staff, payors, patients and families to implement the plan of care.
• Ensure CMS and Kaiser policies compliance and LeV standards are met.
• Transition management: refer post-acute services and follow up on readmissions.
• Educate patients and care team about progression of care and available resources.
• Communicate clinical data to payers to support authorization and level of care.

Skills

Care coordination

Communication skills

Problem solving

Computer literacy

Interdisciplinary collaboration

Education

High School Diploma or GED

Vocational Nurse License (California)

Tools

Health Connect

Tapestry

CERMe InterQual

Case Management System

Job description

Kaiser Permanente in California seeks a LVN/LPN Case Manager Assistant to conduct medical necessity screening and coordinate care under the direction of a Registered Nurse and the interdisciplinary team.

You will manage transition plans with RN/SW input, document in electronic systems, and ensure compliance with CMS and Kaiser policies while advocating for patients and coordinating with payers and care teams.