Your Role

The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior LVN, Care Manager will report to the Manager of Care Management. In this role you will work in the Outreach and Engagement department, and play a pivotal role in reaching out to our members, assessing their needs, and providing comprehensive care coordination. This position requires a proactive individual who can successfully engage and connect members to appropriate health programs and resources.

Your Work

In this role, you will:

• Conduct thorough assessments of member needs, including physical, mental, and social health aspects
• Identify appropriate programs and services that align with member needs and preferences
• Provide Referrals to Quality Management (QM), Disease Management (DM), Complex Care Management (CCM), and Appeals and Grievance department (AGD) 
• Recognize the clients right to self-determination as it relates to the ethical principle of autonomy, including the client/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare team 
• Coordinate with healthcare providers, social workers, and other team members to ensure seamless delivery of care services
• Provide education and support to members and their families regarding health conditions, treatment options, and community resources
• Follow up with members as appropriate to ensure they have successfully connected with recommended programs and services
• Must be able to work 1-2 rotating Saturdays per month

Your Knowledge and Experience

• Requires a current CA LVN License
• Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
• Requires at least 5 years of prior experience in nursing, healthcare or related field
• A minimum of 3 years’ experience in inpatient, outpatient, and/or managed care environment required
• Health insurance/managed care experience is preferred
• Excellent communications skills
• Bilingual is preferred
• Excellent communication and interpersonal skills, with the ability to engage and build rapport with diverse populations
• Demonstrated ability to independently assess, evaluate, and interpret clinical information

Pay Range: 

The pay range for this role is: $ 77990.00 to $ 116930.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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