LPN Care Coordinator

Job Type

Full-time

Description

Job Description:
Collaborates with providers and other members of the healthcare team to identify targeted patient populations within the practice site(s).
Assesses the health care, educational, and psychosocial needs of the patient/family utilizing standardized assessment tools such as depression screening, functionality, and health risk assessment.
Collaborates with providers, patients, and other members of the health care team to monitor the status of individualized plans of care and assist with targeted interventions as appropriate.
Provides patient self-management support with a focus on empowering the patient to achieve optimal health and independence.
Facilitates clinical interventions based on protocols and evidence-based clinical guidelines.
Fosters a team approach and includes patients and their families/caregivers as active members of the team.
Completes timely follow-up with patients discharged from the ED or Inpatient setting: Follow-up may include reviewing discharge instructions and medications, scheduling PCP or specialist follow-up appointments, coordinating necessary services/additional care/equipment/etc. during transitions of care, and problem-solving barriers.
Demonstrates critical thinking skills, as well as positive relationship-building communication skills (both written and verbal).
Maintains required documentation for all patient outreach and care coordination activities.
Works with practice and leadership to continuously evaluate processes, identify problems, and propose/develop process improvement strategies to enhance care coordination services.

Requirements

SKILLS AND ABILITIES
Demonstrates customer-focused interpersonal and communication skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, patients, and families/caregivers.
Demonstrates ability to work autonomously and be directly accountable for assigned duties.
Demonstrates time management, priority setting, and work organization skills.
Demonstrates ability to function effectively in a fluid, dynamic, and rapidly changing environment.

QUALIFICATIONS AND EDUCATION REQUIREMENTS
Current Medical Assistant Certification and/or Registration or Current LPN license
Previous care of patients in primary/ambulatory care or other healthcare facilities, in the past five years
Critical thinking skills and ability to analyze data
Excellent verbal and written communication skills
Excellent interpersonal and facilitation skills.
Ability to affect change, work as a productive and effective team member, and adapt to changing needs/priorities
Demonstrates excellent time management, priority setting, work delegation, and work organization skills

General computer knowledge and capability to use various computer programs