LCMC Health Case Manager in New Orleans, Louisiana

LCMC Health is a Louisiana-based, not-for-profit healthcare system serving the needs of the people of Louisiana, the Gulf South and beyond. LCMC Health currently manages award-winning hospitals including Children's Hospital New Orleans, Touro, New Orleans East Hospital, West Jefferson Holding, LLC, and University Medical Center New Orleans. LCMC Health supports its outstanding local hospitals as they deliver exceptional, compassionate healthcare to the communities they serve. Please explore our website to learn more about the work we do and our commitment to community-focused healthcare.

POSITION SUMMARY:

The LCMC Case Manager will support the Director of Care Management and the Vice President of Population Health/Network Development in designing, implementing, and directing population health management initiatives across the health system. This individual will be part of a team tasked with managing LCMC Health’s transition from volume to value. Foundational to this work will be creating and guiding the development of an LCMC system wide clinically integrated network (CIN) and population health services organization (PHSO). The name of the new organization is LCMC Healthcare Partners. The Case Manager at LCMC will provide care and case management to value based payer members as part of an interdisciplinary care team. The Case Manager will offer: members health and disease education; empower them to actively participate in their care consult with members on their medications and durable medical equipment; review their care plans; address home care needs; and connect them to community resources as needed. The Case Manager collaborates with primary care physicians and other providers to ensure there are no gaps in care, with members, providers, and care givers to ensure positive care outcomes during care transitions from the acute to the home setting. The Case Manager actively participates in program development in collaboration with other members of the interdisciplinary care team.

JOB SPECIFICATIONS:

Education:

Minimum Required: Current unrestricted license as a registered nurse in the state of Louisiana; Preferred:

Experience: Minimum Required: Two years minimum experience with complex case management in a managed care company, hospital or provider office setting Preferred:Previous experience as a case manager for a managed care insurance plan; Case management certification; BSN or experience with discharge planning; Experience in program development

License/Certification: Minimum Required: Current unrestricted license as a registered nurse in the state of Louisiana Preferred: Certified Case Manager

Special Skills/Training: Minimum Required:The ability to work successfully in a stressful environment, relate well to all customers, and maintain expanding knowledge and use of clinic and hospital information systems and population health tools

JOB STANDARDS:

Essential Job Function #1 50.0%

  • Develop individualized care plan, including prioritized goals, that considers the member’s and caregivers’ goals, preferences and desired level of involvement in the case management plan, interventions, and barriers

  • Make outbound calls to assess member’s current health status

  • Identify gaps or barriers in treatment plans

  • Coordinate care for members

  • Make referrals to outside sources

  • Coordinate services such as home health, DME, as needed

  • Ensure members discharging from hospital or ED receive the necessary services and resources, including medication reconciliation

Essential Job Function #2 20.0%

  • Provide patient education to assist with self-management

  • Educate members on disease processes

  • Encourage members to make healthy lifestyle changes

Essential Job Function #3 15.0%

  • Forms partnerships with providers to achieve quality and cost management objectives.

  • Interact with LCMC Healthcare Partners leadership and/or physician group partners to discuss clinical questions and concerns regarding specific cases.

  • Participate in case conferences with the interdisciplinary team to strategize and develop member specific care plans

Essential Job Function #4 15.0%

  • Track and monitor enrolled members throughout the continuum of care

  • Document and track findings in a computerized system

LCMC is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, disability status, protected veteran status, or any other characteristic protected by law.