LPN Care Manager
APS Healthcare - Hilo, HI

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Universal American is a New York Stock Exchange company with annual revenues of more than $2 billion. Through our family of healthcare companies, we provide health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals in order to improve the health and well-being of those we serve and reduce healthcare costs.

Well-capitalized and highly entrepreneurial, Universal American has been on the cutting edge of healthcare for more than 21 years. We offer Medicare Advantage plans to people with Medicare. We partner with providers in Accountable Care Organizations that serve people with Original Medicare. And we provide array of healthcare services to states, municipalities, health plans and other entities in the world of Medicaid. In everything we do, we focus on improving the coordination of healthcare through collaboration between payers, providers and patients to achieve the best health outcomes possible.

For more information on Universal American, please visit our website at www.UniversalAmerican.com.

At APS Healthcare, a subsidiary of Universal American, we are passionate about changing behaviors of all constituents in the healthcare system to improve health, optimize clinical quality, and reduce associated costs. Our mission, quite simply, is to improve the health of those we serve.

APS Healthcare provides comprehensive field and telephonic care management and care coordination services to high-risk members. Our programs support providers and community partners through targeted clinically driven interventions. Members are an integral partner in the treatment team and are supported in making responsible decisions about their healthcare.

APS is seeking a Field-Based Licensed Care Manager (LPN) to join our exciting program. The Care Manager will provide outreach, case management, education and support to plan members to support a healthy lifestyle. The Care Manager Coordinates, monitors and ensures that appropriate services and timely medical/behavioral care are provided to members across the continuum of care. Assists members with developing and implementing social, interpersonal, self care and independent living skills to restore stability and reintegrate member into the community. Promotes effective healthcare utilization and monitors health care resources to achieve optimal clinical and resource outcomes. This position will be based in Hilo, HI and requires travel within the assigned locations.

Responsibilities:
1. Provides continuum of quality care through field-based outreach, education, crisis intervention and other clinically based activities to plan members as specified in their treatment plans.
2. Conducts assessments, develops case management and crisis plans for medical treatment and/or behavioral modification within the scope of practice.
3. Collaborates and coordinates with member’s medical/health and community based providers, as well as medical home, (including the PCP, medical professionals, behavioral health specialists, or others as needed) regarding the member’s treatment/discharge needs and plan of care.
4. Monitors and evaluates the services and community based resources necessary to respond to the individual member’s health needs. Develops relationships with other agencies to support members in attaining services such as housing, entitlements, mental health care, psychiatric medications, medical resources, financial assistance, legal advocacy, etc. Supports the efficient and effective utilization of health care resources which may include transportation or escort to medical appointments.
5. Collects clinical data and maintains accurate records of activities in C3 database for tracking and metrics purposes.
• Collaborates with the Care Management Team to review care management process for members to ensure needs of members are met.
• Participates in on-call rotation.
Qualifications:
• High School Diploma Required. Associates Degree in Practical Nursing. 
Hawaii Licensure: Licensed Practical Nurse (LPN)
• Minimum of three (3) years of relevant health care experience.
• Previous experience providing field based care coordination and/or case management services required.
• Managed care experience preferred
• Previous experience working with SMI or Behavioral Health members preferred.
• Knowledge of adult learning and behavior change principles preferred.
• Knowledge of psychiatric and co-occurring disorders
• Knowledge of community based resources.
• Effective interpersonal and excellent written & verbal communication skills.
• Proficient in Microsoft Office, Internet/Web Navigation.
• Prioritization and organizational skills.
• Drivers License, personal automobile, proof of insurance and satisfactory driving record required.

APS Healthcare - 21 months ago - save job
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