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Form of workJob Description
Empowering Wellness, Transforming Lives
Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, A Positive Choice, and PsycHealth, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.
As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.
Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members.
A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work!
JOB TITLE:LVN Case Manager
Job Summary:The LVN Case Manager efficiently oversees a diverse caseload, conducts regular telehealth meetings with patients, and collaborates closely with healthcare teams to ensure effective care coordination and regulatory compliance. They play a pivotal role in fostering strong patient relationships, managing treatment plans, and providing training on safety and quality assurance.
Duties/Responsibilities:- Manage diverse case portfolio efficiently, including long-term care, mental health, substance abuse, and geriatric care.
- Regularly meet with patients via telehealth to address their healthcare needs.
- Establish and maintain effective relationships with patients, families, and support services.
- Proactively manage caseload in accordance with legislation and best practices.
- Collaborate with service providers on treatment and discharge plans.
- Participate in risk, safety, and quality assurance activities.
- Assist with claims, billing, insurance, and case management.
- Communicate with executives to address concerns promptly.
- Provide training on safety, quality assurance, and regulatory compliance.
- Maintain licensure through continued education.
- Prepare formal responses and reports for regulatory agencies.
- Ensure timely and compliant processes across departments.
- Performs other duties as assigned.
Required Skills/Abilities:
- Experience with Medicare and Medi-Cal environments preferred.
- Knowledge of Core Measures, HEDIS reporting, and basic statistics.
- Ability to manage multiple projects, problem-solve, and work with medical terminology.
- Proficiency in Excel, MS Office, data interpretation, and ability to learn new systems.
- Strong analytical, interpersonal, and communication skills.
- Compassionate, empathetic, and non-judgmental approach to patient care.
- Strong organizational, time management, and clinical judgment skills.
- Excellent verbal and written communication skills.
Education and Experience:
- LVN licensure required, with a minimum of 5 years' experience in acute care and/or ICU/CCU setting.
- Preferred certification in Case Management (e.g., CCMC or ARN).
- Bachelor's or associate degree in nursing, healthcare/business administration, or equivalent experience.
- Minimum 2 years of clinical nursing experience and current California LVN license.
- Current Basic Life Support (BLS) certification.
- 3 years of managed care or healthcare environment experience related to Case Management.
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 10 pounds at times.
Benefits
Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:
Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.
Short & Long-Term Disability Benefits: Protection when you need it most.
Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.
Flexible Spending Accounts: Manage your finances with flexibility.
Employee Assistance Program (EAP): Support when life throws challenges your way.
401(K): Building your financial future with us. Effective after 1 year of employment.
Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.
Paid Holidays: Quality time to enjoy celebrations.
Employee Referral Program: Share the opportunities and reap the rewards.
Company Discount Program: Enjoy savings on everyday expenses and memberships.
Equal Employment Opportunity
Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities.
Pre-Employment
Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.
