Astrana Health, Inc.
Case Manager - LVN (Enhanced Care Management)
Astrana Health, Inc., Monterey Park, California, us, 91756
Case Manager - LVN (Enhanced Care Management)
Department:
HS - ECM Employment Type:
Full Time Location:
1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To:
Colleen Del Valle Compensation:
$28.00 - $38.00 / hour
Description We are currently seeking a highly motivated LVN Lead Care Manager for our Enhanced Care Management (ECM) team. ECM is a Medi-Cal benefit that links high risk members to various resources in the community. You will be responsible for doing assessments and creating care plans based on those assessments for your caseload, as well as following up with members throughout their time in the ECM program.
We are ideally seeking candidates who have prior experience with care management, complex case management, home health, dialysis, D-SNP case management, or managed care.
Our Values:
Put Patients First
Empower Entrepreneurial Provider and Care Teams
Operate with Integrity & Excellence
Be Innovative
Work As One Team
What You'll Do
Comply with organizational policies, department procedures, and Model of Care standards to ensure timely delivery of services to eligible members.
Manage a caseload of 50–100 Medi-Cal members with complex medical, behavioral, and social needs.
Conduct comprehensive assessments, develop individualized care plans, and coordinate care across all transitions (e.g., hospital to PCP) in accordance with DHCS Enhanced Care Management (ECM) requirements.
Collaborate with Community Health Workers and interdisciplinary teams (IDTs/ICTs/MDTs) to address medical and social needs.
Review claims, authorizations, and medication lists to inform care planning and reconciliation.
Verify member eligibility monthly and document all encounters per HIPAA and organizational standards.
Identify barriers to care, educate members and caregivers using evidence-based guidelines, and adjust care plans according to readiness to changes.
Close care gaps and improve health outcomes by supporting HEDIS measure compliance and chronic condition management.
Connect members to social supports such as housing navigation, transportation, and nutrition services.
Facilitate communication with PCPs, specialists, and community partners to ensure coordinated, patient-centered care. Complete administrative duties, including tracking correspondence, sending care plans and program letters, and maintaining accurate records.
Participate in team meetings, trainings, and quality improvement initiatives.
Other duties as assigned.
Qualifications
Current and active LVN CA license
Experience with clinical issues and guidelines
Excellent analytical, critical reasoning, organizational and interpersonal communication skills
Strong written and oral communication skills
Ability to multi-task, work autonomously, and think outside the box
Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information is required.
Proficient with Microsoft Office (Word, Excel, Power Point)
You're great for this role if you have:
Knowledge of enhanced case management, SNP case management, complex case management
Experience in managed care environment – health plans, IPA, or MSO
1+ years of Case Manager experience
Basic knowledge of DHCS, DMHC, NCQA, ICE, and CMS standards
Bachelor's degree
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.
This is a full-time position. Hours are M-F 830 AM - 5 PM.
The total compensation target pay range for this role is between $28 - $38 per hour, depending on credentials and experience. The salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affimative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.
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HS - ECM Employment Type:
Full Time Location:
1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To:
Colleen Del Valle Compensation:
$28.00 - $38.00 / hour
Description We are currently seeking a highly motivated LVN Lead Care Manager for our Enhanced Care Management (ECM) team. ECM is a Medi-Cal benefit that links high risk members to various resources in the community. You will be responsible for doing assessments and creating care plans based on those assessments for your caseload, as well as following up with members throughout their time in the ECM program.
We are ideally seeking candidates who have prior experience with care management, complex case management, home health, dialysis, D-SNP case management, or managed care.
Our Values:
Put Patients First
Empower Entrepreneurial Provider and Care Teams
Operate with Integrity & Excellence
Be Innovative
Work As One Team
What You'll Do
Comply with organizational policies, department procedures, and Model of Care standards to ensure timely delivery of services to eligible members.
Manage a caseload of 50–100 Medi-Cal members with complex medical, behavioral, and social needs.
Conduct comprehensive assessments, develop individualized care plans, and coordinate care across all transitions (e.g., hospital to PCP) in accordance with DHCS Enhanced Care Management (ECM) requirements.
Collaborate with Community Health Workers and interdisciplinary teams (IDTs/ICTs/MDTs) to address medical and social needs.
Review claims, authorizations, and medication lists to inform care planning and reconciliation.
Verify member eligibility monthly and document all encounters per HIPAA and organizational standards.
Identify barriers to care, educate members and caregivers using evidence-based guidelines, and adjust care plans according to readiness to changes.
Close care gaps and improve health outcomes by supporting HEDIS measure compliance and chronic condition management.
Connect members to social supports such as housing navigation, transportation, and nutrition services.
Facilitate communication with PCPs, specialists, and community partners to ensure coordinated, patient-centered care. Complete administrative duties, including tracking correspondence, sending care plans and program letters, and maintaining accurate records.
Participate in team meetings, trainings, and quality improvement initiatives.
Other duties as assigned.
Qualifications
Current and active LVN CA license
Experience with clinical issues and guidelines
Excellent analytical, critical reasoning, organizational and interpersonal communication skills
Strong written and oral communication skills
Ability to multi-task, work autonomously, and think outside the box
Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information is required.
Proficient with Microsoft Office (Word, Excel, Power Point)
You're great for this role if you have:
Knowledge of enhanced case management, SNP case management, complex case management
Experience in managed care environment – health plans, IPA, or MSO
1+ years of Case Manager experience
Basic knowledge of DHCS, DMHC, NCQA, ICE, and CMS standards
Bachelor's degree
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.
This is a full-time position. Hours are M-F 830 AM - 5 PM.
The total compensation target pay range for this role is between $28 - $38 per hour, depending on credentials and experience. The salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affimative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.
#J-18808-Ljbffr