LPN Care Coordinator -CCM/RPM

Job Description

The Care Coordinator is responsible for developing and providing care coordination services directly to Alopex clients’ patients.

Reports To:

• RN Supervisor

Department:

• Clinical Operations

Responsibilities

• Conduct a detailed review of EMR records.
• Develop and maintain individualized Care Plans for management of patients.
• Implement and coordinate all care management activities relating to patients across the continuum of care.
• Communicate with the patient’s clinical care team. Care management must be performed in a timely manner.
• Maintain accurate and detailed documentation related to medication, problems, goals, interventions, preventative care, etc.
• Conduct monthly care calls to the patients enrolled in the program.
• Address all needs/concerns including any follow up needed for patients.
• Educate patients on chronic conditions and reinforce the provider’s directions related to chronic conditions.
• Evaluate and address social determinants to health and begin to link community resources; then, enter them in the system.
• Evaluate/assess medical conditions and be able to identify and address changes in a clinically appropriate manner.
• Adhere to all policies & procedure as outlined by Medicare and Shifox/Alopex
• Perform other duties as assigned.

Requirements

• Bilingual (English/Spanish) Required
• Possess a minimum of two (2) years’ experience providing patient-centered care.
• Possess a minimum of one (1) year experience in skilled nursing.
• Have experience working with electronic medical records.
• Can perform nursing assessments, problem identification, and care plan development.
• Is adaptable to new technology – experience with computer documentation.
• Has excellent time management skills.
• Can assess, evaluate, and problem-solve patients’ conditions and concerns.
• Possesses strong verbal and written communication skills.
• Is meticulous and dedicated to providing accurate documentation.
• Is dependable and focused on achieving goals.

Benefits

• $26 - $27 / hour

Alopex is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.