Care Manager - LVN

Company: Bright Health
Location: Bakersfield
Posted on: March 17, 2023

Job Description:

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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives - apply to join our team.

SCOPE OF ROLE
TheCare Managercoordinates and facilitates members' individualized plan of care in collaboration with members, families, caregivers, and other health care providers. TheCare Manageruses their clinical judgment to determine a member's needs both in the home and throughout an acute care episode. TheCare Managerprovidessupport, guidance, education, and acts as a liaison between the member's PCP and specialty physicians to maximize health outcomes and prevent unnecessary hospitalizations.This rolealso supports a variety of care programs, outreach, education, quality improvement, and other initiatives as needed.
ROLE RESPONSIBILITIES
TheCare Managerjob description is intended to point out major responsibilitieswithin the role, but it is not limited to these items.

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• Conducts face-to-face visits with members in both healthcare facilities and in their homesandinitiates telephone outreach
  
• Facilitate "Intakes" and maintain required documentation in EMR web-based application including but not limited to the following: Surveys, Health Risk Assessments, progress notes, and other documentationas required byBright Health.
  
• Uses all components of the Transition of Care model and nursing process including assessment, triage, planning,implementing,and evaluating care to meet the members' needs
  
• Provides health maintenance,medication,and disease management education to members and families/caregivers
  
• Coordinates appropriate member careappointments, community resources, referrals, management program benefits, and special focus programs
  
• Ensure members' preventive care appointments are scheduled and encourage members to participate in thoseappointments.
  
• Maintains compliance with CMS-mandated health risk assessments,care plans, and interdisciplinary care team requirements.
  
• Active participation inInterdisciplinary Care Teampresentations, if indicated.
  
• Coordinates continuity of care, prevention, and avoidance of complications, and close clinical treatment and management under the direction of the members' primary healthcare provider(s) and medical directors
  
• Takes an active role in coordinating and initiating member's access toBright Health programsand specialty benefits offered beyond traditional Medicare
  
• Effectively communicates, problem-solves, and maintains productive and effective interpersonal relationships while effectively prioritizingpatient care.
  
• Works with outside facilities, agencies, and vendors on a routine basis, maintaining positive working relationships
  
• Supports members and their families/caregivers, and provides compassionate care
  
• Frequent travel is required for member visits, conferences, community events, health fairs, etc.
  
• Make referrals/linkages to community resources on an individualizedbasis.
  
  EDUCATION, TRAINING, ANDPROFESSIONAL EXPERIENCE
  
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  • Current LicensedPracticalNursing or Licensed Vocational Nurse certificate from an accredited Nursing Program
    
  • Two (2) or more years experience as an LPN/LVN, preferably in a case management setting
    
  • Driver's license, auto insurance, and safe driving history
    
  • One (1) year of healthcare-related experience required
    
  • Awareness and experience with HIPAA requirements for healthcare communications preferred
    
  • Prior experience with URAC/NCQA accreditation preferred
    
  • Bilingual preferred in English, Spanish, Chinese, or Vietnamese
    
    PROFESSIONAL COMPETENCIES
    
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    • Excellent communication skills, both oral and written
      
    • Approaches challenges calmly and objectively to identify the best solution
      
    • Capable communicator that can interact with others at multiple levels within the organization, customers, and providers
      
    • Leads through influence and example
      
    • Strong operational mindset and uses data to draw insights
      
    • Thrives on driving results in a collaborative environment
      
      LICENSURES ANDCERTIFICATIONS
      
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      • Current LicensedPracticalNursing or Licensed Vocational Nurse certificate from an accredited Nursing Program; or equivalent combination of education and experience.
        
        WORK ENVIRONMENT
        
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        • The majority ofwork responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
          
        • Travel, up to 10% of the time may be required.
          
          
          For individuals assigned to a location(s) in California, Bright Health is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant's education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $28.31 - $42.47 hourly.
          
          Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; up to 21 days of PTO, 10 paid holidays, plus 2 floating holidays per year; and a lifestyle spending account.
          
          
          We're Making Healthcare Right. Together.
          We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
          
          Focusing on Consumers
          We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
          
          Building on Alignment
          We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
          
          Powered by Technology
          We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
          
          
          
          
          As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
          
          
          
          

Keywords: Bright Health, Bakersfield , Care Manager - LVN, Executive , Bakersfield, California