Licensed Vocational Nurse (Remote) ID- 5601

LVN- Clinical Liaison Care Management Position: 

Position: Clinical Liaison Coordinator /LVN-Care Manager

Location: Home Based /Remote – on-site assessment (local)

Full-time: 8hrs/day/40hrs/wk.

Dates: Monday/Tuesday/Wednesday/ Thursday/Friday

Time: During office hours (9 am -530pm PST)

Salary: $27/hr

The LVN Clinical Liaison is responsible for educating Medi-Cal Members and their families on Medi-Cal specialty programs, such as the Assisted Living Waiver Program (ALWP) and Cal AIM Managed Care Programs, including Enhanced Care Management (ECM) and Community Support (CS) services.  

The Assisted Living Waiver program is designed to assist low-income seniors or adults over 21 with disabilities, giving them an alternative to living at home or in a skilled nursing facility by providing funding to move into the RCFE/ALF care setting.

The Cal AIM Programs offered by Managed Care Plans (MCP) include several specialty programs dedicated to Medi-Cal members.

Enhanced Care Management (ECM) Highlights Enhanced Care Management is a statewide Medi-Cal benefit that addresses the clinical and non-clinical needs of the highest-need Medi-Cal members by building trusting relationships with members and providing intensive coordination of health and health-related services. Lead care managers meet members where they are.

Enhanced Care Management is available to specific groups (called “Populations of Focus”), including:

·       Adults, unaccompanied youth and children, and families experiencing homelessness.

·       Adults, youth, and children at risk for avoidable hospital or emergency department care.

·       Adults, youth, and children with severe mental health and/or substance use disorder needs.

·       Adults living in the community and at risk for long-term care institutionalization

·       Adult nursing facility residents are transitioning to the community.

Community Supports (CS) Highlights Community Supports are statewide services provided by Medi-Cal managed care plans as alternatives to other services covered by Medi-Cal that can help members avoid higher levels of care. Star Nursing offers Community support services including:

·       Housing Transition Navigation Services

·       Housing Deposits

·       Housing Tenancy and Sustaining Services

·       Nursing Facility Transition/Diversion to Assisted Living Facilities

·       Community Transition Services/ Nursing Facility Transition to a Home

The clinical Liaison is responsible for multiple tasks during the workday.  This position prefers a licensed clinical staff member with experience in case management and health care sales in a hospital /LTC/SNF setting and heavy experience in SNF/hospital discharge planning involvement. This Clinical Liaison will work directly with case managers and discharge planners to process Medi-Cal member's referrals in a quick and timely manner. Must have experience with a high-volume workload.  This is a hybrid position, remote and in-patient assessment. In-patient assessment may include SNFs, hospitals, ALFs, member’s homes, or a designated location. This position requires licensed clinical staff with two years of current experience.

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Under the direction of the Director of Case Management, the Clinical Liaison will assist with the following.

  • Intake of incoming new referrals
  • knowledge of Medi-Cal and Medi-Cal programs
  • Contacting discharge planners for additional information needed to process member’s applications
  • Targets key referral sources and establishes ongoing relationships to build awareness of the Cal AIM and Assisted Living Waiver Program and to assure that Star Nursing is the agency of choice for Medi-Cal referrals
  • Must be able to handle the fast-paced flow of work and able to multitask
  • Coordinates tracking of referral sources, assessment of the utilization of services, and preparation of appropriate reports.
  • Work closely with the Director of Case Management
  • Assist with managing the day-to-day operations
  • Coordinate with the facility, member, and family on current health status, resource utilization, past and present treatment plan and services, prognosis, short and long-term goals, treatment, and provider options
  • Ensure urgency with SNF/Hospital/Community referrals, assessments, transitions, placements
  • Determination of eligibility for enrollment in the Medi-Cal program
  • Assist in the review of completed initial assessments and ongoing assessments using the Assessment Tool for accuracy
  • Conduct calls to RCFEs and other providers, helping monitor service delivery by the RCFE and other providers.
  • Maintaining progress notes and case records for each enrolled beneficiary within our Care Management Software
  • Receiving, reviewing, and responding to concerns/complaints from clients, families or friends and forwarding all concerns/complaints to the Department of Health Care Services (DHCS)
  • Reporting all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or neglect occurs in an RCFE) or DHCS and APS (if abuse or neglect occurs in PH).
  • Facilitate member access to community-based services
  • Monitor referrals made to community-based organizations, medical care, and other services to support the members’ overall care management plan
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Coordinate with facility, member, and family on long-term goals, resource utilization, discharge, transition, and admissions to an approved facility
  • Work closely with your team of Patient Care Coordinators (PCC) to ensure prompt placement of Medi-Cal members
  • Responsible for obtaining a signature from members and uploading them as required
  • Participate in case management committees and work on special projects related to case management as needed

Care Plan and Assessment Functions

·       Complete assessments and develop care plans for the Medi-Cal member

·       Review care plans routinely to ensure that appropriate care is being received.

·       Ensure that monthly visit notes reflect the member's needs and goals and that the member follows the care plan.

·       Review patient care plans for appropriate goals, problems, approaches, and revisions based on patient-centered needs.

Patient Rights

·       Maintain the confidentiality of all patient care information.

·       Monitor care to ensure that all patients are treated fairly with kindness, dignity, and respect.

·       Report and investigate all allegations of patient abuse and/or misappropriation of property.

Licensed LVN

Qualifications:

·       Previous experience in care/case management, counseling, or other related field

·       Licensure – LVN or Social Worker

·       Compassionate and caring demeanor

·       Ability to build rapport with clients.

·       Strong leadership qualities

·       Demonstrate effective leadership and management skills.

·       Excellent written and verbal communication skills

·       Have a strong relationship with referral sources

·       Must possess the ability to deal tactfully with personnel, patients, family members, visitors, government agencies/personnel, and the general public.

·       Must be willing to seek out new methods and principles and be willing to incorporate them into existing practices.

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