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Care Manager - LPN/LVN (Bilingual English & Spanish)

Bright Health

Bright Health

Customer Service
California, USA
Posted on Tuesday, October 3, 2023

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Our mission is to make healthcare right. Together. We are a value-driven healthcare company committed to providing personalized care to aging and underserved populations. We do this by aligning stakeholders across the healthcare ecosystem. Together, we can improve consumer experience, optimize clinical outcomes, and reduce total cost of care.

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.


MISSION, VISION AND VALUES

“Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is to collaborate with Care Partners to make health care simpler, personal, and more affordable. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright People to embody and uphold our core values in work and interactions, both internal and external: Be Purposeful, Be Authentic, Be Brave, Be Positive, Be Respectful, and Be Accountable.

SCOPE OF ROLE

The Care Manager coordinates and facilitates members’ individualized plan of care in collaboration with members, families, caregivers, and other health care providers. The Care Manager uses their clinical judgment to determine a member’s needs both in the home and throughout an acute care episode. The Care Manager provides support, guidance, education, and acts as a liaison between the member’s PCP and specialty physicians to maximize health outcomes and prevent unnecessary hospitalizations. This role also supports a variety of care programs, outreach, education, quality improvement, and other initiatives as needed.

ROLE RESPONSIBILITIES

The Care Manager job description is intended to point out major responsibilities within the role, but it is not limited to these items.

  • Conducts face-to-face visits with members in both healthcare facilities and in their homes and initiates telephone outreach
  • Reviewing all data utilized to create the initial Interdisciplinary Care Plan (ICP), such as HRA, claims/pharmacy data, and revise and approve the initial ICP and assigned risk level, if necessary.
  • 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 documentation as required by Bright 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 care appointments, community resources, referrals, management program benefits and special focus programs
  • Ensure member’s preventive care appointments are scheduled and encourage member to participate in those appointments. ​
  • Maintains compliance with CMS mandated health risk assessments, care plans, and interdisciplinary care team requirements.
  • Active participation in Interdisciplinary Care Team presentations, 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 to Bright Health programs and specialty benefits offered beyond traditional Medicare
  • Effectively communicates, problem-solves, and maintains productive and effective interpersonal relationships while effectively prioritizing patient 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 individualized basis. ​

SUPERVISORY RESPONSIBILITIES

This position has no supervisory responsibilities.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Current Licensed Practical Nursing 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
  • Bi-Lingual preferred

PROFESSIONAL COMPETENCIES

  • Prioritizes and plans work activities; uses time efficiently and has the ability to multi-task.
  • 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 AND CERTIFICATIONS

  • Current Licensed Practical Nursing or Licensed Vocational Nurse certificate from an accredited Nursing Program; or equivalent combination of education and experience.

WORK ENVIRONMENT

The majority of work 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 $26.21-$39.32 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.

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.