Medical Case Manager - LVN
Apply NowCompany: CA_CalOptima_CalOptima Health
Location: Orange, CA 92867
Description:
Details
Client Name
CA_CalOptima_CalOptima Health
Job Type
Travel
Offering
Allied
Profession
Allied Health Professional
Specialty
Case Management LPN / LVN
Job ID
16011936
Job Title
Medical Case Manager - LVN
Weekly Pay
$2082.72
Shift Details
Shift
08:00 AM - 05:00 PM
Scheduled Hours
45
Job Order Details
Start Date
02/11/2025
End Date
05/13/2025
Duration
13 Week(s)
Job Description
Due Date- 11 Feb 2025
Submission Information:
The deadline to be guaranteed full review of your submission is due by Tuesday, February 11, 2025 by 9:00 p.m. PST. This position will remain open for a minimum of seven (7) days, but may be extended if a lack of qualified applicants are received or if we are hiring multiple positions.
Duties & Responsibilities:
85% - Program Support
oParticipates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
oAssists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
oPerforms comprehensive assessment of all identified NOAs which includes but is not limited to assessment of the reason for the NOA, coordination with physician reviewers and NOA production and compliance.
oDevelops and implements member specific NOA letters.
oCommunicates with CalOptima Health's physician reviewers, members' physicians, specialists, community agencies and vendors to ensure accurate and complete clinical information is presented.
oFollows CalOptima Health's protocol for documentation.
oWorks collaboratively with interdepartmental staff for NOA resolution.
oIdentifies cases needing review or input from a manager, director or Medical Director and routes accordingly.
oProcesses NOAs with the highest degree of nursing judgment and accuracy.
oCloses cases according to defined case closure procedure in a timely manner and in accordance with established guidelines.
oPrepares and maintains appropriate documentation of patient care and progress within the care plan.
oActs as an advocate in the client's best interest for necessary funding, treatment alternatives, timelines, coordination of care and frequent evaluations of progress and goals.
10% - Administrative Support
oDevelops desktop procedures, assessments and referral templates to facilitate the implementation and compliance with new case management programs or requirements.
5% - Completes other projects and duties as assigned.
Minimum Qualifications:
High school diploma or equivalent required.
3 years of clinical experience required, 1 year of which must be as a UM Clinical Nurse Reviewer or NOA processor.
An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Preferred Qualifications:
3 years of managed care experience.
Required Licensure / Certifications:
Current, unrestricted Licensed Vocational Nurse (LVN) license to practice in the state of California required.
Knowledge & Abilities:
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events.
Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner.
Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees/coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
Ability to visually read information from computer screens, forms and other printed materials and information.
Ability to speak (enunciate) clearly in conversation and general communication.
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
Lifting and moving objects, patients and/or equipment less than 10 pounds
Work Environment:
If located at the 500, 505 Building or a remote work location:
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
There are no harmful environmental conditions present for this job.
The noise level in this work environment is usually moderate.
If located at PACE:
Work is typically indoors in a clinical setting serving the frail and elderly.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.
If located in the Community:
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
Employee will occasionally work outdoors in varied temperatures.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.
Client Details
Address
505 City Parkway West
City
Orange
State
CA
Zip Code
92868
Client Name
CA_CalOptima_CalOptima Health
Job Type
Travel
Offering
Allied
Profession
Allied Health Professional
Specialty
Case Management LPN / LVN
Job ID
16011936
Job Title
Medical Case Manager - LVN
Weekly Pay
$2082.72
Shift Details
Shift
08:00 AM - 05:00 PM
Scheduled Hours
45
Job Order Details
Start Date
02/11/2025
End Date
05/13/2025
Duration
13 Week(s)
Job Description
Due Date- 11 Feb 2025
Submission Information:
The deadline to be guaranteed full review of your submission is due by Tuesday, February 11, 2025 by 9:00 p.m. PST. This position will remain open for a minimum of seven (7) days, but may be extended if a lack of qualified applicants are received or if we are hiring multiple positions.
Duties & Responsibilities:
85% - Program Support
oParticipates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
oAssists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
oPerforms comprehensive assessment of all identified NOAs which includes but is not limited to assessment of the reason for the NOA, coordination with physician reviewers and NOA production and compliance.
oDevelops and implements member specific NOA letters.
oCommunicates with CalOptima Health's physician reviewers, members' physicians, specialists, community agencies and vendors to ensure accurate and complete clinical information is presented.
oFollows CalOptima Health's protocol for documentation.
oWorks collaboratively with interdepartmental staff for NOA resolution.
oIdentifies cases needing review or input from a manager, director or Medical Director and routes accordingly.
oProcesses NOAs with the highest degree of nursing judgment and accuracy.
oCloses cases according to defined case closure procedure in a timely manner and in accordance with established guidelines.
oPrepares and maintains appropriate documentation of patient care and progress within the care plan.
oActs as an advocate in the client's best interest for necessary funding, treatment alternatives, timelines, coordination of care and frequent evaluations of progress and goals.
10% - Administrative Support
oDevelops desktop procedures, assessments and referral templates to facilitate the implementation and compliance with new case management programs or requirements.
5% - Completes other projects and duties as assigned.
Minimum Qualifications:
High school diploma or equivalent required.
3 years of clinical experience required, 1 year of which must be as a UM Clinical Nurse Reviewer or NOA processor.
An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Preferred Qualifications:
3 years of managed care experience.
Required Licensure / Certifications:
Current, unrestricted Licensed Vocational Nurse (LVN) license to practice in the state of California required.
Knowledge & Abilities:
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events.
Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner.
Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees/coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
Ability to visually read information from computer screens, forms and other printed materials and information.
Ability to speak (enunciate) clearly in conversation and general communication.
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
Lifting and moving objects, patients and/or equipment less than 10 pounds
Work Environment:
If located at the 500, 505 Building or a remote work location:
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
There are no harmful environmental conditions present for this job.
The noise level in this work environment is usually moderate.
If located at PACE:
Work is typically indoors in a clinical setting serving the frail and elderly.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.
If located in the Community:
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
Employee will occasionally work outdoors in varied temperatures.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.
Client Details
Address
505 City Parkway West
City
Orange
State
CA
Zip Code
92868