Bilingual LVN Case Manager, Outpatient - Must have California LVN license

Job Number: 6386
Workplace Type: Fully Remote
Position Title:Case Manager
External Description:
Overview of the Role:
Alignment Health is seeking a bilingual LVN Case Manager to join the case management, outpatient team. As an LVN Case Manager, you will be responsible for for health care management and coordination, within the scope of licensure, for members with complex and chronic care needs. As the LVN Case Manager, you will deliver care to members utilizing the nursing process and effectively interacts with members, care givers, and other interdisciplinary team participants. You will also assist with closing gaps in care and resolving barriers that prevent members from attaining improved health. The LVN Case Manager will connect with members telephonically.
Responsibilities:

• Coordinate care by serving as a resource for the member, their family and their physician.
• Ensure access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate.
• Complete comprehensive assessments within their scope of practice that includes assessing the member's current health status, resource utilization, past and present treatment plan and services.
• Collaborate with the member, the primary care physician (PCP) and other members of the care team to implement a plan of care.
• Interface with PCPs, hospitalists, nurse practitioners (NP) and specialists on the development of care management treatment plans.
• Provide education and self-management support based on the member's unique learning style.
• Assist in problem solving with providers, claims or service issues.
• Work closely with delegated or contracted providers, groups or entities to assure effective and efficient care coordination.
• Maintain confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy.

Requirements:

• Minimum 1-3 years' clinical experience, 2 or more years of case management experience; or any combination of education and experience, which would provide an equivalent background.
• Health plan experience preferred
• Must have and maintain an active, valid, and unrestricted LVN license in California.
• Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs
• Extensive knowledge of the management of chronic conditions
• Bilingual English and Spanish, Vietnamese, or Chinese preferred
• Excellent verbal and written communications skills
• Team player who builds effective working relationships
• Able to work independently
• Experience using standardized clinical guidelines required
• Strong organizational skills
• Able to operate PC-based software programs including proficiency in Word, Excel and PowerPoint

Pay range: $70,000-$105,600 annually.
City: Remote - CA
State: California
Location City: Remote - CA
Location State: California
Community / Marketing Title:Bilingual LVN Case Manager, Outpatient - Must have California LVN license
Company Profile:
By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?
At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that's in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career - with us.
EEO Employer Verbiage:
Please note: All clinical positions are contingent upon successful engagement with Alignment Health's COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
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