Case Manager (LVN/RN) - Temporary

$62,400 - $93,600/Yr

Astrana Health - Monterey Park, CA

Full-time - Mid Level

Hybrid - Monterey Park, CA

5,001-10,000 employees

About the position

The Case Manager (LVN/RN) position at Astrana Health is a temporary role focused on managing patient care transitions in skilled nursing facilities. The role involves collaboration with healthcare providers to ensure compliance with care management standards and effective discharge planning. This hybrid position requires both in-office and remote work, emphasizing the need for strong organizational and communication skills.

Responsibilities

• Comply with Case Management Department's policies and procedures
• Ensure 95 - 100% compliance with Utilization Management health plan delegation standards for Case Management
• Utilize Milliman Care Guidelines, CMS, Title 22 guidelines for transition of care appropriateness
• Collaborate with Hospitalists, case managers, and discharge planners to establish discharge plans at admission
• Coordinate initial and concurrent reviews based on medical records and report admissions to Medical Director and Manager
• Review medical records to determine medical necessity and appropriateness of care
• Assess, plan, implement, coordinate, monitor, and evaluate options and services to reduce hospital readmission
• Attend/coordinate Case Management meetings on and off-site as necessary
• Communicate determination outcomes to providers or members in compliance with requirements
• Maintain relationships with health plans, facilities, and medical directors
• Report daily activities and problems to Manager/Supervisor of Case Management

Requirements

• Bachelor's degree in Nursing or LVN
• Active Licensed Vocational Nurse (LVN) or Registered Nurse (RN) license in California
• Ability to commute to Monterey Park, CA office
• Experience using Microsoft applications such as Word, Excel, and Outlook
• Two (2) years of clinical experience as an LVN
• Skilled Nursing Facility experience is a plus

Nice-to-haves

• Experience using EZCAP
• Excellent analytical critical reasoning skills
• Ability to prioritize multiple responsibilities in a fast-paced environment
• Experience in educating and training staff members
• Strong communication and customer service skills
• Detail-oriented with good organization and problem-solving skills

Benefits

• Competitive hourly wage of $30 - $45
• Temporary contract position
• Hybrid work environment (in-office and remote)