LPN Care Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Provide Transitional Care and Chronic Care Management services

• Evaluate EMR records to guide initial outreach and focus areas for care planning

• Conduct thorough assessments of physical and psychosocial risk factors

• Recognize and address challenges related to individual patient needs

• Communicate assessment results, care plan objectives, interventions, and outcomes to providers, patients, and caregivers

• Track patients’ emergency department visits and acute care stays

• Conduct post-discharge follow-up calls and continually assess readmission risks

• Utilize motivational interviewing techniques to enhance patient engagement and self-management skills

• Offer education on chronic diseases and teach symptom management

• Maintain proactive communication with providers about changes in patient status and necessary referrals or orders

• Record care plans, clinical interventions, and outreach activities in the care management software system

• Establish and nurture professional relationships with assigned providers and care management team members

⛳️ Requirements

• High school diploma or equivalent is mandatory

• Associate's or Bachelor's degree is preferred

• Must hold a valid LPN/LVN or Registered Nurse license

• A minimum of two (2) years of experience in care coordination, particularly related to post-discharge transitions of care, is required

• Experience in providing care coordination to skilled nursing and/or Medicare beneficiary populations is essential

• Preferred experience with SNF-to-home transitions of care or SNF bundled payment care coordination

• Proficient knowledge and experience with electronic medical records (EMR) and care management technologies

• Excellent customer service skills with a patient-centric focus

• Capacity to work flexibly in an ambiguous and dynamic environment

• Strong skills in collaboration and conflict resolution

• Exceptional decision-making and problem-solving abilities

• Ability to engage with diverse populations and provide culturally sensitive coaching, education, and support

• Proficient in developing, prioritizing, and achieving goals; effective time management skills

🏝️ Benefits

• Excellent health insurance options including Medical, Vision, and Dental

• Short-term disability coverage

• Life insurance policy

• Critical illness insurance

• Generous paid time off (PTO) package

• Time off on selected holidays

• Highly competitive salary

• Generous bonus potential

• 401(k) plan with an annual contribution of 2-3%