Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaningbehind Caring. Connecting. Growing together.

The LVN Case Manager is responsible for patient case management for longitudinal engagement, coordination for discharge planning, transition of care needs and outpatient patient management through the care continuum. You will determine medical appropriateness of outpatient services following evaluation of medical guidelines and benefit determination. This includes case management, coordination of care and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for patients. This role acts as a support to team members, coaching, guiding and providing feedback as necessary. The LVN Case Manager will act as an advocate for patients and their families and guide them through the health care system for transition planning and longitudinal care. You will be part of a interdisciplinary team.

Primary Responsibilities:

• Engage patient, family, and caregivers telephonically to assure that a well-coordinated action plan is established and continually assess health status
• Provide member education to assist with self-management goals; disease management or acute condition and provide indicated contingency plan
• Identify patient needs, close health care gaps, develop action plan and prioritize goals
• With oversight of RN and/or MD, utilizing evidence-based practice, develop interventions while considering member barriers independently
• Provide patients with "welcome home" calls to ensure that discharged patients’ receive the necessary services and resources according to transition plan
• In partnership with care team triad, make referrals to community sources and programs identified for patients
• Collaborates effectively with Interdisciplinary Care Team (IDCT) to establish an individualized transition plan and/or action plan for patients

This is an office base position near Capitol HWY 360 near the Presidio Bldg.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Current, unrestricted LPN/LVN license, specific to the state of employment or compact license
• 2 years of managed care and/or case management experience
• 2 years of years of clinical experience
• Knowledge of managed care, medical terminology, referral process, claims and ICD-10 codes

Preferred Qualifications:

• Case Management certification 
• Experience in planning, organizing, conflict resolution, negotiation and interpersonal skills to work with autonomy in meeting case management goals and initiatives
• Knowledge of utilization management and/or insurance review processes as well as current standards of care, a solid knowledge of health care delivery systems and the ability to interact with medical directors, physician advisors, clinicians and support staff 
• Proficient computer skills in Microsoft applications and Microsoft Excel