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LPN Outpatient Care Coordinator
2 months ago
Summit Medical Group is seeking a highly skilled LPN Outpatient Care Coordinator to join our team. As a key member of our care coordination team, you will play a vital role in ensuring seamless transitions of care for our patients.
Key Responsibilities- Transition of Care Services: Provide comprehensive transition of care services to patients post-inpatient hospitalization or emergency room visit, ensuring a smooth and efficient transfer of care.
- Communication and Collaboration: Initiate and maintain effective communication with the multi-disciplinary healthcare team to develop, implement, and evaluate a transition plan of care for SMG patients.
- Care Needs Assessment: Assess the complexity of care needs and potential/actual issues, identifying opportunities for improvement and implementing strategies to address them.
- Referral Coordination: Arrange post-discharge referrals to Care Management RN, SW, and other community resources as needed, ensuring timely and effective care coordination.
- Quality Metrics: Assist with meeting quality metrics, ensuring that our patients receive high-quality care and services.
- Patient Education: Educate patients on the appropriate use of emergency services, primary care, specialists, and urgent care, promoting informed decision-making and self-management skills.
- Treatment Plan Facilitation: Facilitate patient understanding of the physician's treatment plan, including medication adherence, preventive care, and self-management skills.
- Medical Information Sharing: Facilitate the sharing of medical information across the continuum of care, ensuring that all relevant stakeholders have access to accurate and timely information.
- Documentation and Record-Keeping: Document transition of care encounters and other clinical correspondence in the electronic medical record (EMR), maintaining accurate and up-to-date records.
- Patient Advocacy: Act as an advocate for patients' health care needs, identifying and communicating potential needs to the patient's provider.
- Collaboration and Partnerships: Collaborate with skilled nursing facilities, home health agencies, and other community partners to ensure ongoing care, support, and education for our patients.
- Confidentiality and Security: Maintain the security and privacy of patients' care information, adhering to strict confidentiality standards.
- Training and Development: Participate in required training and attend team, departmental, and organizational meetings, staying up-to-date on best practices and industry developments.
- Quality Improvement: Monitor and improve the quality of services provided to patients/caregivers through ongoing participation in team and departmental quality improvement activities.
- Job Knowledge and Skills: Update job knowledge by participating in educational opportunities that support the advancement of Care Coordination, including care transitions.
- Team Support: Participate in the orientation and training of new staff as needed, supporting the growth and development of our team members.
- Education: High School Diploma or equivalent required; additional vocational or college credits preferred.
- Experience: Minimum 1 year of clinical experience required.
- Certification/License: Valid State of Tennessee Licensed Practical Nurse License required; valid Driver's License preferred.
