A Clinical Case Manager coordinates medical care and provides advocacy to help people get the best and most affordable care. Helps patients navigate insurance and hospital bureaucracies and access information. May work with patients who have chronic illnesses or other complex medical needs. Works at a hospital or other healthcare facility; may follow patients throughout the span of their treatment and travel to different doctors' offices, hospitals or a patient's home.
Medical Case Manager (LVN) Aroha Technologies - 3.8 Orange, CA Job Details Temporary | Contract $37.43 - $45.00 an hour 1 hour ago Qualifications Microsoft Excel Microsoft Outlook LVN Word embeddings High school diploma or GED Full Job Description Temporary Medical Case Manager (LVN)
CalAIM Location:
505
City Parkway West, Orange County, CA Job Type:
Temporary /
Contract Assignment Duration:
Up to 6 months
Schedule:
Monday Friday, 8:00 AM 5:00
PM Work Arrangement:
Fully Onsite Pay:
$37.43 $45.00 per hour, W-2 Target compensation is expected to be around the mid-range or below, depending on qualifications and experience. About the Role We are seeking an experienced Licensed Vocational Nurse (LVN) to join our CalAIM team as a Temporary Medical Case Manager . This position supports care coordination and utilization management activities for CalAIM services, ensuring requests are reviewed appropriately and members receive timely, high-quality support. The ideal candidate will have strong clinical judgment, excellent communication skills, and the ability to work independently in a fast-paced healthcare environment. Experience with managed care or authorization review is highly preferred. Key Responsibilities Review authorization requests for CalAIM services for medical appropriateness using established clinical criteria, policies, and procedures. Verify and process CalAIM referrals received through healthcare systems, telephone, and fax. Apply established clinical protocols to determine medical necessity. Coordinate member care with health networks, healthcare providers, internal teams, patients, and families. Accurately document authorization decisions, clinical information, and updates in utilization management or care management systems. Determine the appropriate action for requested services, including approval, modification, or denial. Refer cases to the Medical Director for review when appropriate. Contact members, families, and CalAIM providers to obtain additional information as needed. Support department goals and priorities while maintaining a member-focused, mission-driven approach. Meet established productivity, quality, documentation, and performance standards. Collaborate effectively with internal departments and external healthcare partners. Perform other duties and projects as assigned. Required Qualifications Current, unrestricted California LVN license required. High school diploma or equivalent. At least 3 years of nursing experience. Strong clinical judgment and problem-solving skills. Excellent verbal and written communication abilities. Ability to work independently and manage multiple priorities. Proficiency with Microsoft Office applications, including Word, Outlook, Excel, and PowerPoint. Ability to work effectively in a fast-paced environment. Preferred Qualifications Experience in managed care . At least 1 year of authorization review experience . Experience with utilization management, care management, or medical necessity review. Bilingual in English and one of the following threshold languages: Arabic, Farsi, Chinese, Korean, Spanish, or Vietnamese . Yashika Jaint Healthcare Recruiter 510-400-6494 #LPN2026
