Your Role

The Children's Services Program (CSP) team provides identification, referrals, and care management for all Medi-Cal members under 21 years old and collaborates within Promise Clinical Team. The Case Management LVN Consultant will report to the CSP Manager. In this role you will be perform clinical review, assessment, evaluation of medical services for the organization using the established and approved Blue Shield Medical Policies and CCS/EIES/ DDS/CSHCN/EPSDT eligibility guideline which align with nationally recognized standards.

Responsible for managing member needs for specific CCS/EIES/DDS/CSHCN/EPSDT and other clinical programs and care coordination. Responsible in assisting and working daily inventory, providing high-quality clinical reviews, performing efficient case management and care coordination, and ensuring compliance performance metrics are met. In addition, the CM LVN Consultant will assist the CSP Managers in improving operational processes and implementation of new regulatory requirements. They would also assist in training and developing CSP staffs performance.