Case Manager, LVN - Bilingual English & Spanish (Work from Home)

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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.

The role of the Case Manager is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure member’s receive services and resources required to meet desired health and social outcomes. The Case Manager is responsible for providing patient centered care across the care continuum.

ROLE RESPONSIBILITIES

• Collect relevant clinical data to support the care planning process
• Care Plan support, intervention, and prioritization to transition members to optimal levels of health and self-management
• Participate in interdisciplinary team meetings as required
• Collaboration across providers and healthcare settings to ensure optimal quality outcomes for an assigned population
• Provide transition of care interventions as required
• Facilitate care coordination, self-management planning, discharge planning, and health education for an assigned population
• Facilitate linkage to appropriate community resources to address social determinants of health
• Adjudicate referrals and apply evidence-based clinical criteria to coordinate member care needs across all care setting
• Ensure member communication and notices are composed in a manner consistent with regulatory standards
• Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

LICENSURES AND CERTIFICATIONS

PROFESSIONAL COMPETENCIES

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.