Lpn Care Coach

Summary

Join CircleLink Health® as a remote Care Coach, working 20-25 hours per week with a team of nurses to manage patients with chronic conditions in Medicare's Chronic Care Management program. You will educate patients on self-management, implement and improve their plan of care, utilize motivational interviewing techniques, conduct transitional care management, reduce care gaps, and connect patients with community resources. This 1099 contract position requires a current, unrestricted Compact LPN license, 5+ years of experience as an LPN, proficiency with electronic health records, and strong communication and problem-solving skills. Compensation is based on clinical encounters and additional incentives are available for patient withdrawals and unsuccessful contact attempts. The position is remote and offers flexibility within specified hours.

Requirements

• Be fluent in English
• Meet communication skills, must be self-directed, able to work independently with little supervision while meeting performance metrics
• Have a passion for nursing
• Be detail-oriented
• Possess excellent organizational and time management skills
• Possess strong communication and telephonic skills
• Possess strong critical thinking and problem-solving skills
• Commit to a certain number of hours per day and days of the week
• Be available to make calls on weekdays between 9am-6pm ET
• This role cannot be held alongside a full-time position
• Have a strong internet-connected computer (LPN)
• Have a current, unrestricted Compact LPN license
• Be proficient with electronic health records and web-based applications
• Have 5+ years experience as a Licensed Practical Nurse

Responsibilities

• Educate patients on self-management skills and goal setting
• Implement and improve the Plan of Care by updating medications, appointments due, record biometrics, vital signs, and care coaching provided
• Utilize Motivational Interviewing or other behavior change techniques to coach and assist the patient with self-management
• Conduct Transitional Care Management activities to high risk patients discharged from the hospital and the ER to reduce unnecessary readmissions, including medication reconciliation, medication adherence, identify red flags, address barriers, encourage follow-up care, how and when to seek appropriate level of care
• Reduce care gaps by encouraging or assisting with preventive care, and chronic care management, i.e. annual well visits, follow up visits, medication management, pre-visit labs, diagnostic tests due, preventive cancer screens
• Connect the patient with community resources as needed, including transportation, personal care needs, homemaker or chore services, social services, etc

Preferred Qualifications

• Have Case Management or Chronic Disease Management experience
• Have Case Management Certification
• Be a Certified Diabetes Educator
• Have Transitional Care Management experience
• Have experience with Motivational Interviewing or other behavior change communication techniques

Benefits

• Remote work
• Flexible hours (within specified timeframe)