Episodic Case Manager, LVN

Job not on LinkedIn

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $35 - $40 / hour

⏰ Full Time

🟢 Junior

👔 Manager

👻 Ghost score 0%

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MedPOINT Management

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1988

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

MedPOINT Management is a California-based healthcare management services organization that supports independent practice associations (IPAs), provider networks, hospitals and contracted health plans with clinical quality, care management, administrative operations and technology solutions. For more than 32 years MPM has provided services including provider network operations, case management, utilization management, claims operations, credentialing, HEDIS/STARs quality measurement and analytics (via Cozeva), call center and financial management, and digital provider portals and resource libraries. The company emphasizes data security and compliance (SOC 2 and HITRUST e1 certifications for its EZ-CAP and Provider Web Portals) and focuses on enabling value-based care, quality improvement, and operational support for providers and payers.

📋 Description

• Assess, plan, implement, monitor, and evaluate options and services to develop patient-focused action plans • Act as patient advocate throughout the continuum of care and facilitate communication among physicians, patients, and families • Monitor patient care to ensure quality care using standards of care and practice guidelines • Perform medical, functional, safety, nutritional, and psychosocial assessments for assigned caseloads • Document issues, problems, interventions, and follow-up notes in the preferred documentation module • Communicate sensitively and timely with patients, families, and significant others regarding patient care • Identify support systems from family and community resources • Participate in Interdisciplinary Care Team, Case Management, and IPA meetings/rounds as needed • Coordinate specialist visits, durable medical equipment, home health, prior authorization, and other member needs • Collaborate with the Social Work team to coordinate care and services • Refer members to eligible Health Plan programs, including Complex Case Management, Disease Management, Palliative Care, and MLTSS • Maintain communication with health plans, physicians, hospitals, extended care facilities, members, MPM departments, and co-workers regarding referrals • Ensure cases are coded accurately for reporting of members referred to health plan programs • Adhere to HIPAA confidentiality regulations and policies • Assist with orientation and training for new employees as needed • Perform other assigned tasks and show initiative

🎯 Requirements

• Current California RN/LVN License • Acute Care experience • 1–2 years’ experience in Basic/Complex Case Management a plus • 1 year experience in Managed Care • Understanding of the managed care philosophy, including advanced knowledge of HMO policies and procedures and the managed care industry • Familiarity with Case Management Policies and Procedures, standards of practice and its function • Ability to triage, prioritize, and identify urgent versus non-urgent matters • Ability to manage diverse areas of understanding and interface effectively with employees, members, employers, MPM personnel, and providers • Basic office and computer skills; computer literacy • Detail orientation and strong verbal and written communication skills • Bilingual is a plus • EZ-CAP and ESSETTE knowledge is a plus

🏖️ Benefits

• 401(k) • 401(k) matching • Dental insurance • Health insurance • Vision insurance • Wellness resources