LPN Care Coordinator
Alliance Family Health Center Inc, Alliance, OH, United States
Benefits
401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
JOB DESCRIPTION
LPN Care Coordinator
Alliance Family Health Center, Inc.
BASIC FUNCTION
The LPN Care Coordinator, in alignment with the goals of Alliance Family Health Center and PCMH (Patient Centered Medical Home), is responsible for activities including disease management, referral coordination, hospital follow up for high-risk patients, and integration of evidence-based clinical and prevention guidelines into care. The Care Coordinator will promote team-based care to provide health services to individuals, through effective partnerships with patients, their caregivers/families, community resources, and their physician.
JOB DUTIES
Use data systems to monitor gaps in care and oversee scheduling of patient appointments for needed services.
Coordinates continuity of care with external healthcare organizations, including facilitating hospital follow-up and referrals to a specialty care provider or community resources.
Proactively reach out to high-risk patients, obtain consent, and manage patient care.
Conduct monthly touch points with patients to evaluate goal attainment and health management; celebrate successes and provide suggestions about how to overcome barriers.
Track referrals and open orders in conjunction with AFHC Referral Specialist.
Perform medication management, including reconciling discharge medications with ongoing medication regimen and develop a patient-directed self-management strategy for compliance.
Acts as patient and care team liaison to assist all patients through the healthcare system by engaging as a patient advocate and navigator.
Supports patient self-management of disease and behavior modification interventions.
Develop and maintain positive relationships with patients by providing ongoing support for the patient and their family.
Facilitates discussion and promotes clear communication amongst care teams by ensuring adherence of patient care plans.
Participates in all care team activities such as provider meetings, team huddles, and quality improvement initiatives.
Assesses patient health, education, and psychosocial needs using standardized assessment tools.
Provides health and disease education in a meaningful and relevant manner.
Prepares necessary reports, exam notes, laboratory results and other related documents prior to patient appointments.
Maintains required documentation for all care management activities in EHR; maintaining up to date patient records with information on specialist consults, hospitalizations, and ER visits.
In coordination with AFHC BHIC develop and implement standards and workflows for PCMH recognition.
In coordination with AFHC BHIC obtain and maintain PCMH recognition.
Demonstrate customer focused interpersonal skills to interact in an effective manner with practitioners, care teams, community agencies, patients, and families with diverse opinions, values, religious, and cultural ideals.
Demonstrate ability to develop positive, longitudinal relationships and set appropriate boundaries with patients and families.
Works under the guidance of the AFHC colleague handbook
Maintain patient confidentiality by following HIPAA and Notice of Privacy Practices.
HEALTH CARING STANDARDS
Greet customers, visitors, and Colleagues immediately with a smile, warm greeting, and introduction, calling them by name if possible.
Exceed the expected and anticipate the unexpected by asking, “Is there anything else I or a fellow colleague can do for you?”
Always provide a comforting, timely, caring departure or discharge, and always say thanks for allowing us to serve.
Integrity, openness and fairness in all you do
Teamwork
Pride in Health Center
Individual creativity and Innovation
Compassion and caring
Maintain department and hospital standards and policies.
AGE APPROPRIATE CARE
Colleague has been instructed in providing customer service and on interacting with age groups as related to the department's general client population: including use of appropriate interventions, communication and skills to match the age and/or abilities of the patient/family.
MACHINES, TOOLS & EQUIPMENT USED
Office equipment (copy machine, fax machine, telephone), Athena EHR, Computer Software
AED, Sterilizer, BP cuffs, Otoscope, glucose monitor, other medical equipment as appropriate.
EDUCATION, TRAINING & EXPERIENCE
Minimum two years’ experience in a clinical setting
Graduate of Accredited Licensed Practical/ Vocational Nursing Program or Registered Nursing Program
Experience in care coordination, patient navigation, or population health required.
Active LPN/RN license required.
Current CPR certification required.
SKILLS REQUIRED
Medical terminology and pharmacology required.
Knowledge of chronic conditions, evidence-based guidelines, prevention, wellness, and health risk assessments.
Ability to manage complex clinical issues utilizing assessment tools and protocols.
Focus on detail and self-motivated with ability to work with little supervision.
Problem solving, conflict resolution, critical analysis skills.
Proficient in Microsoft Office
Excellent organizational skills
Experience with computer technology
Detail oriented and self-motivated
Excellent customer service skills
PHYSICAL REQUIREMENTS
Normal space, ventilation, and noise levels
Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of this position can be fully met.
Must be able to get up and down out of chair frequently throughout the shift.
Must be able to lift 40 lbs.
Must be able to verbalize well and possess manual dexterity to write legibly.
RESPONSIBLE TO
Behavioral Health Integration Coordinator
Chief Operations and Compliance Officer
This description is intended to describe the essential job duties and the essential requirements for the performance of this job.
#J-18808-Ljbffr
401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
JOB DESCRIPTION
LPN Care Coordinator
Alliance Family Health Center, Inc.
BASIC FUNCTION
The LPN Care Coordinator, in alignment with the goals of Alliance Family Health Center and PCMH (Patient Centered Medical Home), is responsible for activities including disease management, referral coordination, hospital follow up for high-risk patients, and integration of evidence-based clinical and prevention guidelines into care. The Care Coordinator will promote team-based care to provide health services to individuals, through effective partnerships with patients, their caregivers/families, community resources, and their physician.
JOB DUTIES
Use data systems to monitor gaps in care and oversee scheduling of patient appointments for needed services.
Coordinates continuity of care with external healthcare organizations, including facilitating hospital follow-up and referrals to a specialty care provider or community resources.
Proactively reach out to high-risk patients, obtain consent, and manage patient care.
Conduct monthly touch points with patients to evaluate goal attainment and health management; celebrate successes and provide suggestions about how to overcome barriers.
Track referrals and open orders in conjunction with AFHC Referral Specialist.
Perform medication management, including reconciling discharge medications with ongoing medication regimen and develop a patient-directed self-management strategy for compliance.
Acts as patient and care team liaison to assist all patients through the healthcare system by engaging as a patient advocate and navigator.
Supports patient self-management of disease and behavior modification interventions.
Develop and maintain positive relationships with patients by providing ongoing support for the patient and their family.
Facilitates discussion and promotes clear communication amongst care teams by ensuring adherence of patient care plans.
Participates in all care team activities such as provider meetings, team huddles, and quality improvement initiatives.
Assesses patient health, education, and psychosocial needs using standardized assessment tools.
Provides health and disease education in a meaningful and relevant manner.
Prepares necessary reports, exam notes, laboratory results and other related documents prior to patient appointments.
Maintains required documentation for all care management activities in EHR; maintaining up to date patient records with information on specialist consults, hospitalizations, and ER visits.
In coordination with AFHC BHIC develop and implement standards and workflows for PCMH recognition.
In coordination with AFHC BHIC obtain and maintain PCMH recognition.
Demonstrate customer focused interpersonal skills to interact in an effective manner with practitioners, care teams, community agencies, patients, and families with diverse opinions, values, religious, and cultural ideals.
Demonstrate ability to develop positive, longitudinal relationships and set appropriate boundaries with patients and families.
Works under the guidance of the AFHC colleague handbook
Maintain patient confidentiality by following HIPAA and Notice of Privacy Practices.
HEALTH CARING STANDARDS
Greet customers, visitors, and Colleagues immediately with a smile, warm greeting, and introduction, calling them by name if possible.
Exceed the expected and anticipate the unexpected by asking, “Is there anything else I or a fellow colleague can do for you?”
Always provide a comforting, timely, caring departure or discharge, and always say thanks for allowing us to serve.
Integrity, openness and fairness in all you do
Teamwork
Pride in Health Center
Individual creativity and Innovation
Compassion and caring
Maintain department and hospital standards and policies.
AGE APPROPRIATE CARE
Colleague has been instructed in providing customer service and on interacting with age groups as related to the department's general client population: including use of appropriate interventions, communication and skills to match the age and/or abilities of the patient/family.
MACHINES, TOOLS & EQUIPMENT USED
Office equipment (copy machine, fax machine, telephone), Athena EHR, Computer Software
AED, Sterilizer, BP cuffs, Otoscope, glucose monitor, other medical equipment as appropriate.
EDUCATION, TRAINING & EXPERIENCE
Minimum two years’ experience in a clinical setting
Graduate of Accredited Licensed Practical/ Vocational Nursing Program or Registered Nursing Program
Experience in care coordination, patient navigation, or population health required.
Active LPN/RN license required.
Current CPR certification required.
SKILLS REQUIRED
Medical terminology and pharmacology required.
Knowledge of chronic conditions, evidence-based guidelines, prevention, wellness, and health risk assessments.
Ability to manage complex clinical issues utilizing assessment tools and protocols.
Focus on detail and self-motivated with ability to work with little supervision.
Problem solving, conflict resolution, critical analysis skills.
Proficient in Microsoft Office
Excellent organizational skills
Experience with computer technology
Detail oriented and self-motivated
Excellent customer service skills
PHYSICAL REQUIREMENTS
Normal space, ventilation, and noise levels
Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of this position can be fully met.
Must be able to get up and down out of chair frequently throughout the shift.
Must be able to lift 40 lbs.
Must be able to verbalize well and possess manual dexterity to write legibly.
RESPONSIBLE TO
Behavioral Health Integration Coordinator
Chief Operations and Compliance Officer
This description is intended to describe the essential job duties and the essential requirements for the performance of this job.
#J-18808-Ljbffr