19 days old

LVN Case Manager

La Palma, CA 90623
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AppleCare Medical Group, part of OptumCare, is a group of leading, independent physicians that provide excellent care and quality service. Our doctors work with a team of AppleCare nurses, social workers and pharmacists to provide expert, personalized care.  AppleCare Medical Group is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.

The SNP CMC Case Manager is responsible for managing low and moderate risk Special Needs Population (SNP) and Dual Eligible (DE) members.  SNP / CMC Care Manager will ensure that the SNP and DE receive an assessment.  Ensures the individualized care plan is developed and presented timely to the IDCT.

*This is an office - based, telephonic position, located in La Palma, CA

Primary Responsibilities:

  • Case Management including, but not limited to, the management and coordination of care for high risk, transplant, CCS and CPSP populations. 

  • Managers a case load of 400-600 low to moderate risk SNP and or CMC members.

  • Coordinates and schedules all IDCT meetings

  • Ensures all SNP and DE members are presented at IDCT at least annually

  • Facilitates Primary Care Provider attendance

  • Ensures SNP and DE member and or caregiver participation

  • Obtains the health plan HRA from various websites

  • Oversees the low risk SNP and DE population and ensures the annual review of the care plan is completed for those members who did not have a change in health status.

  • Manages all communication and information flow

  • Completes the model of care training annually

  • Works collaboratively with the patient, physician, family/significant other and providers of healthcare to implement plan of care to meet the individual needs.

  • Works collaboratively with discharge planners at the affiliated hospitals and case management staff to identify changes in health status.

  • Coordinates referrals to LTSS as indicated. 

  • Provides patients with education and training regarding specific health care needs.

  • Monitors care, which is easily accessible with no access barriers as related to the patient's available benefits.

  • Facilitates early and intensive treatment intervention in the least restrictive setting.

  • Facilitates the scheduling of follow up services as appropriate.

  • Provides accurate and up-to-date information to practitioners regarding clinical practice guideline criteria and patient information.

  • Creates  individualized treatment plans that incorporate the HRA, community LTSS services

  • Utilizes multidisciplinary clinical, rehabilitative and support services.

  • Grants adequate attention to patient satisfaction through the evaluation and improvement of the care coordination process.

  • Upholds strict rules of confidentiality.

  • Provides ongoing Care coordination program analysis and development. 

  • Encourages collaborative collegial approaches to the Case Management process.

  • Promote the Care coordination Program's viability and accountability.

Posted: 2020-03-11 Expires: 2020-04-27

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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LVN Case Manager

UnitedHealth Group
La Palma, CA 90623

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