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LVN Well Med at Singing Hills
3 months ago
Incentive Bonus 2 times a year
18 days of PTO & Closed on Major Holidays
401K Match
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
The Healthcare Coordinator is responsible for successfully supporting patients with high risk health conditions to navigate the healthcare system. The Healthcare Coordinator assists in developing patient empowerment by acting as an educator, resource, and advocate for patients and their families to ensure a maximum quality of life. The Healthcare Coordinator interacts and collaborates with multidisciplinary care teams, to include physicians, nurses, pharmacists, laboratory technologists, social workers, and other educators to support the transition of care process. The Healthcare Coordinator acts as a resource for clinic staff. The Healthcare Coordinator works in a less structured, self-directed environment and performs all nursing duties within the scope of a LVN/LPN license of the applicable state board of nursing.
Primary Responsibilities:
- Works with the providers and clinic staff to identify patients at high risk through transitions of care. This is to support the market initiative of reducing utilizations, including ER visits, hospital admissions, and hospital readmissions
- Supports longitudinal care of the patient with chronic care conditions by:
- performing assessment of health conditions
- initiating medication reconciliation for PCP to complete
- conducting Motivational Interviewing and Self-Management Goal setting
- providing patient education
- Supports transition of the patient with chronic care conditions from inpatient to outpatient setting, by:
- performing assessment of transitional needs
- initiating medication reconciliation for PCP to complete
- establishing and reviewing contingency plan and 24/7 patient support availability
- providing patient education in a self-management format
- completing 3 in 30 on all high risk members experiencing a discharge
- ensure a 7 calendar day follow up with PCP post discharge
- assisting with post discharge needs such as prescriptions, transportation, Durable Medical Equipment (DME), appointments by creating and following up on social work referrals
- refers to case management for complex case needs, longitudinal needs, and/or disease management
- Coordinate with providers to establish or update plan of care
- Performs accurate and timely documentation in the electronic medical record
- Participates in daily huddles and Patient Care Coordination (PCC) meetings
- Prepares accurate and timely reports, as required, for weekly meetings
- Maintains continued competence in nursing practice and knowledge of current evidence based practices
- May perform clinical tasks within their scope of practice
- Performs all other related duties as assigned
Required Qualifications:
- Licensed Practical/Vocational Nurse with an active and unrestricted license to practice in the state of employment
- Current BLS certification
- 2+ years of experience in a physician's office, clinical or hospital setting
- Knowledge of chronic diseases, especially COPD/asthma, diabetes, CHF and IHD
- Proficient computer skills to work efficiently with electronic medical records
- Proven excellent verbal and written skills
- Proven solid interpersonal skills
- Proven ability to interact productively with individuals and with multidisciplinary teams
- Proven excellent organizational and prioritization skills
- IV Certification
- Experience related to patient education and/or motivational interviewing skills and self-management goal setting
- Experience with outbound patient telecommunications
- Fluent written and verbal skills in English and Spanish
Physical & Mental Requirement:
- Ability to stand for extended periods of time
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
