LVN Outreach Intake Specialist - Bilingual | Merced

Job Category

Overview

Sub Category :
Licensed Practical Nurse & Licensed Vocational Nur

Description

Job Summary: The Bilingual LVN Outreach Intake Specialist’s main duties will be to work with newly enrolled members and collect all necessary data and documentation.

• Completing the outreach and enrollment forms that required from the health plans, such as the comprehensive assessment form and other required forms.
• Collecting member’s clinical notes from the PCP office.
• Ensuring newly enrolled members are not in duplicative programs.
• Other ECM duties assigned by supervisor.

Essential Functions:

• Capable of conducting in-person meetings with members as required for comprehensive intake assessments.
• Works closely with the outreach team to welcome newly enrolled members and complete their initial assessments before conducting warm handoffs with the to-be-assigned Lead Care Managers (LCMs).
• Reviews data and interviews potential members to verify eligibility for enrollment in the Enhanced Care Management program (ECM) and completes the referral process when necessary.
• Conducts appropriate member assessments mainly In-Person.
• Coordinates with individuals and/or entities to ensure a seamless experience for the member and ensure non-duplication of services.
• Oversees provision of ECM services, including the completion of member assessments, development of member Care Management Plans (CMP), provide educational and community resources.
• Documents evidence of care in the member’s record in a concise and timely manner using the EHR system.
• Routinely checks-in or schedules appointments with assigned members and maintains documentation of all member encounters to complete established reporting requirements.
• Partners with healthcare professionals, community and social support services, and other healthcare entities to coordinate care and locate member resources.
• Actively manages assigned patient cases to ensure coordination of care, retention of patients, and ensuring a high level of care coordination is maintained.
• Addresses members questions and processes member requests in a timely manner.
• Identifies, coordinates, and follows-up on member needs to ensure continuity of care, and member needs are being met.
• Investigates and directs members’ inquiries or complaints to appropriate staff members and follows up to ensure satisfactory resolution.
• Understands and abides by all departmental and company wide policies and procedures.
• Complies with all safety and injury prevention policies and regulations.
• Assists in leading the services provided to the eligible and enrolled members and ensuring ongoing compliance with state regulations and company policies and procedures.

Required Skills/Abilities:

• Able to abide by federal, state and local regulatory requirements as they related to case management and social services and operate within the guidelines.
• Competent with computers, email, virtual platforms, Excel and other Microsoft Office based programs.
• Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear, effective manner.
• Ability to identify problems and use logic and related information to develop and implement solutions.
• Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures.

Physical Requirements: Physical demands associated with office work and driving, including but not limited to:

• Consistently operating a computer and other office equipment such as a telephone, calculator, copy machine, and printer.
• Must be able to remain in a stationary position 75% of the time.
• Must be able to move around the office or community 50-80% of the time.
• Frequently…