Licensed Practical Nurse- Care Coordinator

As one of the nation's Top 15 Health Systems, recognized by Premier and Modern Healthcare, Valley Health is a place where excellence, compassion, and purpose come together. This distinction reflects our commitment to exceptional patient care, clinical quality, and the caregivers who make it all possible.

Pay Range: $22.71 - $34.06

Job Description

• Collaborate with RN Care Coordinator to manage a patient panel of up to 250.
• Perform periodic holistic care management based on initial assessment and goals as outlined by RN Care Coordinator.
• Provide education regarding disease management based on current best practice standards.
• Identify patients who may need closer follow up and escalate care to RN Care Coordinator as appropriate for re-evaluation and triage.
• Knowledge of current federal, state, and local programs as well as their eligibility requirements and application process in order to pro-actively connect patients with appropriate resources.
• Implement care management plan and goals established by RN Care Coordinator and mutually agreed upon by patient/family.
• Utilize motivational interviewing techniques and assist patient in meeting action-oriented goals and objectives.
• Evaluate effectiveness of plan in meeting established care goals.
• Collaborate with RN Care Coordinator in instances where goals may need to be revised.
• Interacts professionally with patient/family to achieve maximum levels of wellness and independence.
• Perform weekly follow up calls for patients recently discharged from the hospital who are considered high risk for readmission until patient has been discharged for 30 days.
• Ensure that the patient has attended follow up appointments as scheduled and is adherent to medications.
• Provide patient with education regarding hospital diagnosis.
• Identify patients who have had a change in condition and escalate care to RN Care Coordinator for further evaluation/triage.
• Serve as liaison to providers, patients and families for coordination of services
• Maintains EMR databases on care managed population.
• Maintain accurate and timely documentation and billing based on care plan initiated by RN Care Coordinator.
• Identify patients who have had a change in condition and escalate care to RN Care Coordinator for review of care plan.
• Review utilization and quality reports routinely, scan for gaps in care and identify patients needing the additional support of care management.
• Participates in regular team meetings.
• Participates in departmental and organizational committees as applicable.
• Participates in the orientation of new personnel.
• Precepts and acts as a mentor to peers.
• Promotes collaborative teamwork.
• Meet with RN Care Coordinator team lead and Manager Population Health Outpatient Care Coordinator on a regular basis to provide patient updates, identify issues, and develop strategies for resolution.
• Performs all duties and responsibilities in accordance with basic principles and guidelines of professional nursing.
• Ensures documentation meets current standards and policies.
• Attend conferences, workshops, and complete continuing education as assigned.

Education

• High School Diploma required

Certification & Licensures

• LPN License required.
• Based on primary state of residency and in accordance with current Virginia Board of Nursing Regulations, must be licensed or eligible to practice pending licensure as a Licensed Practical Nurse in the Commonwealth of Virginia and/or West Virginia (as applicable depending upon geographical area assigned) with either a: Multi-State License, under the Nurse Licensure Compact required.
• BLS Certification (Basic Life Support) - American Heart 'Healthcare Provider' (HCP) - AHA approved required.
• New hires must have American Heart Association (AHA) appropriate certification prior to completion of orientation.

Qualifications

• Experience in an outpatient setting as an advocate role for a community health services position preferred
• Basic knowledge of medical terminology preferred
• Ability to interact with other professionals as part of a multidisciplinary team
• Experience with word processing package such as Microsoft Office desirable
• Valid driver's license based on primary state of residency
• Ability to travel to meet with clients/attend business functions/trainings/meetings at all VH work sites required
• Knowledgeable in the cognitive, physical, emotional, and chronological stages of human growth and development required
• Communicates Effectively And Works Cooperatively With Others Required
• Knowledge of funding, resources, clinical standards and outcomes for population required

Benefits

At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include:

• A Zero-Deductible Health Plan
• Dental and vision insurance
• Generous Paid Time Off
• Tuition Assistance
• Retirement Savings Match
• A Robust Employee Assistance Program to help with many aspects of emotional wellbeing
• Membership to Healthy U: An Incentive-Based Wellness Program

Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more. To see the full scale of what we offer, visit valleyhealthbenefits.com.