LVN Out-Patient Case Manager

US-CA-Commerce
Job ID
2017-5334
Category
Nursing

Overview

The LVN Case Manager may provide daily care coordination, case management, coaching, consultation and intervention to patients with one or more chronic diseases. Is responsible for identifying said population via provider/clinic referral, utilization management referral, disease registry reporting mechanisms and patient self-referral. This position will also provide case management to patients who are admitted to the hospital and those patients who may need to be enrolled in ambulatory case management. Works as part of an interdisciplinary care team coordinating social work and mental health counseling, psycho-social support services, in-home support, legal services, skilled nursing, home health, etc. The LVN Case Manager effectively collaborates with the members of the interdisciplinary care team and with the physician in the clinic.

 

Responsibilities

  1. Follows established policies, procedures, workflows, and desktop procedures of the department.
  2. Assist in the collection of date during the assessment process.
  3. Effectively and efficiently manages patients throughout the continuum of care.
  4. Works collaboratively with care teams to provide holistic patient care that is focused on high quality in a cost effective way.
  5. Develops a working relationship with the hospital case managers, health plan, clinics, and other governing entities.
  6. Provides input on the development of quality care plan.
  7. Implements the care plan under the guidance of the RN.
  8. Assist in performing and documenting patient outreach telephonic and or face to face to reduce the likelihood of readmissions and responsibilities including but not limited to PCP appointments, ensure DME Home Health is ordered, referring for social barriers for referrals to social workers.
  9. Performs and document patient telephonic and/or person-to-person health risk questionnaire.
  10. Performs other related duties as assigned.

I. MEETS PERFORMANCE REQUIREMENTS

  • Meet the established Performance & Productivity Targets. Measurement: department’s Performance Metrics.
  • Effective time management demonstrated by meeting the established turn-around times and all regulatory and health plan requirements. Measurements: Receive >95% on monthly quality audits, Meet 5 day turn-around times for discharged members.
  • Managing multiple priorities, demonstrated by ease and productivity to transition between multiple tasks. Measurement, Department Performance Measure.
  • Team player, achieved through assisting co-workers with their workload as asked by the Lead or others and be able to have cross-training to fill in when needed.

  • Highly effective communication with members, external constituents, and internal stakeholders.

II. EXCEEDS PERFORMANCE REQUIREMENTS

All items listed under “Meets Expectations”, and:

  • Problem solving skills demonstrated by identification, recommendation, and implementation of tactics and approaches to improve productivity and team work.

  • Taking initiative demonstrated by consistent and active participation, to be a positive change agent, to problem solve, identify and offer suggestions to improve outcomes in Case Management, and to assist others as needed.

  • Leading by example. Be the role model in offering supportive care to patients, and consistently meet needs

III. MEETS PERFORMANCE REQUIREMENTS

  • Meet the established Performance & Productivity Targets. Measurement: department’s Performance Metrics.

  • Effective time management demonstrated by meeting the established turn-around times and all regulatory and health plan requirements. Measurements: Receive >95% on monthly quality audits, Meet 5 day turn-around times for discharged members.

  • Managing multiple priorities, demonstrated by ease and productivity to transition between multiple tasks. Measurement, Department Performance Measure.

  • Team player, achieved through assisting co-workers with their workload as asked by the Lead or others and be able to have cross-training to fill in when needed.

  • Highly effective communication with members, external constituents, and internal stakeholders.

IV.EXCEEDS PERFORMANCE REQUIREMENTS

All items listed under “Meets Expectations”, and:

  • Problem solving skills demonstrated by identification, recommendation, and implementation of tactics and approaches to improve productivity and team work.

  • Taking initiative demonstrated by consistent and active participation, to be a positive change agent, to problem solve, identify and offer suggestions to improve outcomes in Case Management, and to assist others as needed.

  • Leading by example. Be the role model in offering supportive care to patients, and consistently meet needs of the external and internal customers.

 

Qualifications

  1. Graduation from an accredited LVN nursing program.

  2. Current valid License as a Licensed Vocation Nurse

  3. Experience in and willingness to be part of multi-disciplinary team.

  4. The LVN CM is part of a cohort of LVN’s, Social Workers, and Care Coordinators that are support and guided by an RN Case Manager.

  5. Experience with physically or mentally impaired adults and/or geriatric population.

  6. Three years experience in public health nursing, acute care, case management and/or in-home health care required; minimum of 2 years of managed care experience in case management with focus in inpatient and/or outpatient ambulatory care preferred.

  7. Bilingual in English and Spanish preferred.

 

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