Care Management LVN (Compact Licensed), Remote

Company Description: Clearlink Partners is an industry-leading managed care consultancy specializing in end-to-end clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special Needs Plans, complex care populations, and risk-adjusted entities. We support organizations as they navigate a dynamic healthcare ecosystem by helping them manage risk, optimize healthcare spend, improve member experience, accelerate quality outcomes, and promote health equity. Position Responsibilities: Specific • Manage expenses, facilitate access and improve quality of life for persons with long-term chronic conditions and/ or high risk, high cost disease states (Disease and/ or Chronic Condition Management) • Work with patients in distinct populations and sub-populations to promote global outcomes, optimize health, manage care and control costs (Population Health) • Assist with empowering the member to manage and improve their health, wellness, safety, adaptation, and self-care through effective care coordination, case management • Educate member/caregivers about treatment options, community resources, insurance benefits, etc • Engage member to complete health and psychosocial assessment, taking into account the cultural and linguistic needs of each member • Assess, develop, implement, document, coordinate, monitor, manage, evaluate and update comprehensive individualized care plans (ICP) designed to provide evidence based care to meet member needs • Employ ongoing assessment and documentation to evaluate member response to and progress on the ICP • Identify and manage barriers to achievement of care plan goals • Identify and implement effective interventions based on clinical standards and best practices • Collaborate with members of an inter-disciplinary care team (ICT) to identify member needs and opportunities that would benefit from care coordination to achieve goals and maximize member outcomes • Act as a liaison to collaborate with facility based case managers, provider and care transition/ discharge planners to plan for post-discharge care needs or facilitate transition to an appropriate level of care in a timely and cost-effective manner • Coordinate with community-based case managers, service providers and community resource agencies to ensure coordination and avoid duplication of services • Appropriately terminate care coordination services based upon established case closure guidelines • Provide clinical oversight and direction to unlicensed team members as appropriate General • Works under the direction/supervision of an RN, with overall responsibility for the member's case • Perform daily work with a focus on the core principles of managed care: Patient Education, Wellness and Prevention Programs, Early Screening and Intervention and Continuity of Care • Contributes to the care coordination process, performing activities within the scope of licensure • Assisting with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs • Assists in identifying members for high risk complications • Obtains clinical data as directed to support the care management process • Assists in identifying members that would benefit from an alternative level of care or services • Provides all information collected to the responsible RN • Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed to ensure cost effective and efficient utilization of health benefits • Collaborate with team members to expedite the care process • Work collaboratively across the health care spectrum to improve quality of care • Leverage experience/expertise to observe performance and suggest improvement initiatives • Contribute actively and effectively to team discussions • Share knowledge and expertise, willingly and collaboratively. • Provide outstanding customer service, internally and externally • Follow and maintain compliance with regulatory agency requirements Position Qualifications: Competencies: • Decision making skills require an understanding of disease processes, medical terminology and application of clinical guidelines but, do not require independent nursing/ clinical judgement • Ability to identify potential member needs for consideration and incorporation into the plan of care • Ability to collaborate with others, exercising sensitivity and discretion as needed • Strong understanding of managed care environment with population management as a key strategy • Strong understanding of the community resource network for supporting at risk member needs • Ability to collect, stage and evaluate data to identify potential gaps in care and interventions • Understanding of physical health, behavioral health, social services, community services and supports • Ability to work under pressure while managing competing demands and deadlines • Well organized with meticulous attention to detail • Strong sense of ownership, urgency, and drive Experience: • Current unencumbered Compact LPN license • 2+ years of care management experience in managed care environment, CM certification preferred • Strong knowledge of care management/ population health processes and industry best practice • Detailed knowledge of SDOH frameworks and community resource networks • Minimum of 5+ years of clinical experience • Minimum 2 years of managed care experience across multiple lines of business (Medicare Advantage, Managed Medicaid, Dual SNP, Commercial, etc.) • HMO and risk contracting experience preferred • Excellent oral and written interpersonal/communication, internal/external customer-service, organizational, multitasking, and teamwork skills. • Proficiency in Microsoft Office • Excellent time management and /problem-solving skills. • The ability to work effectively in a fast-paced environment with frequently changing priorities, deadlines, and workloads. • The ability to offer positive customer service to every internal and external customer Physical Requirements: • Must be able to sit in a chair for extended periods of time • Must be able to speak so that you are able to accurately express ideas by means of the spoken word • Must be able to hear, understand, and/or distinguish speech and/or other sounds in person, via telephone/cellular phone, and/or electronic devices • Must have ample dexterity which allows entering of text and/or data into a computer or other electronic device by means of a keyboard and/or mouse • Must be able to clearly use sight so that you are able to detect, determine, perceive, identify, recognize, judge, observe, inspect, estimate, and/or assess data or other information types • Must be able to fluently communicate both verbally and in writing using the English language • Must be able to engage in continuous social interaction, successfully manage stressful high conflict situations, and balance multiple duties, expectations and responsibilities simultaneously Time Zone: Eastern or Central Other Information: • Expected Hours of Work: Friday 8a.m. – 5 p.m.; with ability to adjust to Client schedules as needed • Travel: May be required, as needed by Client • Direct Reports: None • Salary Range: $50,000 – $80,000 EEO Statement: It is Clearlink Partners’ policy to provide equal employment opportunity to all employees and applicants without regard to race, sex, sexual orientation, color, creed, religion, national origin, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit-based factor in accordance with all applicable laws, directives and regulations of Federal, state and city entities. This salary range reflects the minimum and maximum target wage for new hires of this position across all US locations. Individual pay will be influenced by Experience, Education, Specialized Soft Skills, and/or Geographic location. Apply tot his job Apply To this Job