Post-Acute Case Manager

JOB SUMMARY

The Post-Acute Case Manager (LVN) performs concurrent and retrospective utilization review, care coordination, transition of care, and discharge planning activities for members across the continuum of post-acute care settings, including skilled nursing facilities (SNFs), long-term acute care hospitals (LTACHs), inpatient rehabilitation facilities (IRFs/ARUs), home health, hospice, assisted living, and select acute care settings. Working within a California-based healthcare Management Services Organization (MSO), this role supports the delivery of medically necessary, high-quality, and cost-effective care in compliance with applicable federal and state regulations, including CMS, Medi-Cal, and California Department of Managed Health Care (DMHC) requirements.

Under the direction of an RN, Medical Director, or other licensed clinical leader as required by California scope-of-practice laws, the Case Manager collaborates with providers, facilities, interdisciplinary teams, members, caregivers, and health plans to support appropriate level of care, length of stay management, discharge planning, prevention of avoidable readmissions, and safe transitions across the continuum of care.