UM LVN Inpatient Case Manager

Medica Talent Group; Montebello (CA); On-site; USD 45,000 - 63,000; Full time

Job summary

Medica Talent Group is seeking an experienced Licensed Vocational Nurse (LVN) Case Manager to support the Utilization Management department of a healthcare organization in Montebello, CA. The LVN Case Manager will provide care coordination, concurrent reviews, and case management services for patients admitted to hospitals and skilled nursing facilities (SNFs).

This position works closely with interdisciplinary healthcare teams to ensure appropriate levels of care, facilitate discharge planning,

Qualifications

• Graduate of an accredited LVN program.
• Active, unrestricted California LVN license.
• Minimum of 3 years of experience in public health nursing, acute care, case management, and/or home healthcare.
• Minimum of 2 years of managed care case management experience, with a focus on inpatient and/or outpatient ambulatory care.
• Current Basic Life Support (BLS) certification.
• Knowledge of utilization management, clinical review processes, and discharge planning.
• Strong communication, critical thinking, organizational, and documentation skills.

Responsibilities

• Conduct daily concurrent and retrospective reviews for hospitalized patients and those in SNFs.
• Review prior authorization and pre-certification requests using established clinical criteria.
• Coordinate discharge planning and transitions of care to ensure appropriate patient services.
• Collaborate with hospitalists, physicians, social workers, and interdisciplinary care teams.
• Identify and coordinate cases requiring additional services, referrals, or ambulatory case management.
• Review and process referral authorizations within established turnaround times.
• Assist with patient outreach, follow-up appointments, home health services, and DME coordination.
• Maintain accurate case management documentation and ensure compliance with health plan requirements.
• Support efforts to reduce hospital readmissions and improve continuity of care.

Skills

Public health nursing

Discharge planning

Care coordination

Communication

Bilingual (English/Spanish)

Education

LVN program graduate

Tools

InterQual criteria

Job description

LVN Inpatient Case Manager – Utilization Management

Position Details

• Pay Rate:$33–$46 per hour
• Location:Montebello, CA 90640 (Onsite)
• Schedule:Monday–Friday, 8:00 AM–5:00 PM
• Assignment Type: Temporary
• Assignment Length: Through December 31, 2026, with potential for extension based on business needs
• Start Date:ASAP

Job Summary

Medica Talent Group is seeking an experienced Licensed Vocational Nurse (LVN) Case Manager to support the Utilization Management department of a healthcare organization in Montebello, CA. The LVN Case Manager will provide care coordination, concurrent reviews, and case management services for patients admitted to hospitals and skilled nursing facilities (SNFs). This position works closely with interdisciplinary healthcare teams to ensure appropriate levels of care, facilitate discharge planning, and support positive patient outcomes.

Key Responsibilities

• Conduct daily concurrent and retrospective reviews for hospitalized patients and those in skilled nursing facilities.
• Review prior authorization and pre-certification requests using established clinical criteria.
• Coordinate discharge planning and transitions of care to ensure appropriate patient services.
• Collaborate with hospitalists, physicians, social workers, and interdisciplinary care teams.
• Identify and coordinate cases requiring additional services, referrals, or ambulatory case management.
• Review and process referral authorizations within established turnaround times.
• Assist with patient outreach, follow-up appointments, home health services, and durable medical equipment (DME) coordination.
• Maintain accurate case management documentation and ensure compliance with health plan requirements.
• Support efforts to reduce hospital readmissions and improve continuity of care.

Qualifications & Requirements

Required:

• Graduate of an accredited Licensed Vocational Nursing (LVN) program.
• Active, unrestricted California LVN license.
• Minimum of 3 years of experience in public health nursing, acute care, case management, and/or home healthcare.
• Minimum of 2 years of managed care case management experience, with a focus on inpatient and/or outpatient ambulatory care.
• Current Basic Life Support (BLS) certification through the American Heart Association or American Red Cross.
• Knowledge of utilization management, clinical review processes, and discharge planning.
• Strong communication, critical thinking, organizational, and documentation skills.
• Ability to work effectively within a multidisciplinary healthcare team.

Preferred:

• Bilingual in English and Spanish.
• Experience with InterQual clinical criteria and prior authorization processes.
• Familiarity with health plan regulations, case management models, and community healthcare resources.
• Previous experience coordinating care for hospitalized patients and skilled nursing facility residents.

Why Join Us?

This opportunity offers the chance to contribute to a collaborative healthcare team while supporting effective care coordination and improved patient outcomes.