JOB SUMMARY

The Care Management LVN serves as a clinical resource for Care Management review staff, providing guidance on procedures, standards, workflows, and program compliance. This role oversees daily case review workflows, auditing processes, ensures delivery of excellent customer service that aligns with organizational expectations, and manages a patient case load. The Care Management LVN evaluates patient needs, determines program eligibility, and develops care plans that promote optimal clinical outcomes, high-quality care, efficient resource utilization, and patient satisfaction.

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: High School diploma or equivalent required. Graduate of an accredited Licensed Vocational Nursing program.

Preferred: Additional coursework in Case Management or Managed Care.

Experience

Minimum: 2+ years of inpatient or care management review experience in a managed care organization or healthcare facility.

Preferred: Experience in ambulatory case management and/or high-risk patient programs.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Certification(s)

Active, unrestricted California LVN License

Certified Case Manager (CCM) credential (preferred).

Skills, Knowledge & Abilities

· Strong knowledge of healthcare delivery, case management principles, and managed care operations.

· Proficiency in Microsoft Office (Word, Excel, Outlook, Access, PowerPoint).

· Ability to type at least 40 WPM with accuracy.

· Excellent communication, interpersonal, and customer-service skills.

· Ability to prioritize, problem-solve, and work independently with minimal supervision.

· Skilled in documentation, time management, and maintaining compliance with regulations.

· Ability to collaborate across multidisciplinary clinical teams.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. This role is primarily sedentary, with most time spent seated for computer work, documentation, and phone communication. Limited standing, walking, and occasional driving to clinical sites are required. The position may involve light physical tasks such as lifting up to 20 pounds, occasional bending, reaching, and climbing stairs throughout the day. The work requires strong analytical skills, attention to detail, emotional resilience when managing complex or high-risk cases, and the ability to multitask in a fast-paced environment. Work is performed mainly in a standard office setting with regular use of computers and office equipment, with occasional exposure to clinical environments such as hospitals, clinics, or skilled nursing facilities.

PAY RANGE

$35.00 - $40.00 / hourly