Senior Case Manager, RN/LVN | Care Transitions Expert

Astrana Health, Inc.; Monterey Park (CA); Híbrido; USD 48.000 - 62.000; Jornada completa

Descripción de la vacante

Astrana Health, Inc. is seeking a Case Manager II (RN or LVN) in Monterey Park, CA to manage a complex caseload across acute inpatient and post-acute settings. You will review records, coordinate care, and engage with Members and families to support safe transitions and reduce readmissions.

The role requires strong clinical judgment, collaboration with Hospitals and health plans, and the ability to work in a hybrid onsite/remote schedule. 2+ years of case management experience is preferred.

Formación

• Active RN or LVN license in good standing in the applicable state.
• Minimum two (2) years of clinical experience as an RN/LVN.
• Demonstrated experience in Case Management, Utilization Management, acute care, post-acute care, or a related clinical setting.
• Strong written and verbal communication skills and ability to collaborate with Members, families, providers, facilities, and interdisciplinary teams.

Responsabilidades

• Comply with Case Management, Utilization Management, health plan delegation, regulatory, and accreditation requirements.
• Independently manage a complex mixed caseload across acute inpatient, SNF, rehabilitation, and other post-acute settings, with timely follow-up and accurate documentation.
• Review medical records and other clinical documentation to assess medical necessity, appropriateness, level of care, skilled needs, and transition-of-care needs using criteria and guidelines.
• Coordinate initial and concurrent clinical reviews and communicate findings, barriers, and escalations to leadership as appropriate.
• Collaborate with Hospitalists, facility Case Managers, discharge planners, PCPs, specialists, Members, families, and other care partners to establish safe discharge plans.

Conocimientos

RN/LVN license

Clinical case management experience

Strong communication

Microsoft Word/Excel/Outlook

Herramientas

Microsoft Word

Excel

Outlook

Descripción del empleo

Astrana Health, Inc. is seeking a Case Manager II (RN or LVN) in Monterey Park, CA to manage a complex caseload across acute inpatient and post-acute settings. You will review records, coordinate care, and engage with Members and families to support safe transitions and reduce readmissions.

The role requires strong clinical judgment, collaboration with Hospitals and health plans, and the ability to work in a hybrid onsite/remote schedule. 2+ years of case management experience is preferred.