Case Manager; LVN OR RN - SNF

Case Manager (LVN OR RN) - SNF

Location: 1600 Corporate Center Dr., Monterey Park, CA 91754

Compensation: $34.00 - $45.00 / hour

Department: HS - ICM

Job Title: Case Manager I or II

Astrana is looking for a RN/LVN Case Manager and we are willing to train a RN or LVN with no case management experience! You will have the ability to work with pediatric and/or adult populations depending on business need.

• Comply with Case Management Department’s policies and procedures
• 95-100% compliance with Utilization Management health plan delegation standards for Case Management
• Utilize Milliman Care Guidelines criteria for appropriateness of transition to care by level of skilled needs and acute rehab for post discharge plan
• Collaborate with Hospitalists, case managers, and discharge planners to establish discharge plans at time of admission
• Coordinate the required initial and concurrent reviews based on the review of medical records and daily accurate reporting of all inpatient admissions
• Review medical records and documentation to determine medical necessity, appropriateness, and level of care using Milliman Care and guidelines
• Assess, plan, implement, coordinate, monitor, and evaluate options and services to reduce hospital readmission; attend/coordinate Case Management meetings on and off‑site as needed
• Interact with providers or members to communicate determination outcomes in compliance with state, federal, and accreditation requirements
• Attend to provider and interdepartmental calls with exceptional customer service
• Maintain good relationships with health plans, hospitals, and medical directors; resolve problems that arise with any IPA medical directors
• Report to Manager and/or Supervisor of Case Management on activities and problems throughout the day
• Be available for Hospital site Case Management
• Other duties as assigned

• Active Registered Nurse (RN) license in California OR active Licensed Vocational Nurse (LVN) license in California
• Experience using Microsoft applications such as Word, Excel, and Outlook
• At least two (2) years of clinical experience as an RN/LVN

• Excellent analytical, critical reasoning skills
• Proven ability to prioritize multiple responsibilities simultaneously in a fast‑paced, changing environment while meeting deadlines
• Ability to educate and train staff members and other departments as needed
• Experience using EZCAP
• Strong communication and customer service skills

• Hybrid work structure: both in office and at home on a weekly basis; position located at 1600 Corporate Center Dr., Monterey Park, CA 91754
• Requires visiting patients in partnered hospitals
• The target pay range for this role is $34.00 - $45.00 per hour; actual compensation will be based on geographic location, experience, and other factors

Associate

Full‑time

Health Care Provider

Hospitals and Health Care

Astrana Health is proud to be an Equal Employment Opportunity and affirmative action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need.

If you require assistance in applying for open positions due to a disability, please email us at humanre to request an accommodation.

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.