Job Title: Nurse Coordinator
Monroe Regional Hospital (Aberdeen, MS) is seeking an experienced LPN who, under the direction of an RN or practicing Physician, will be responsible for assisting with the continuity of care for Medicare Advantage (Healthy Mississippi) members including clinic, ancillary, outpatient and inpatient settings. Job functions will be performed via telephone and Virtual meetings. The LPN is responsible for following defined outreach protocols and utilizing approved resources to enhance quality outcomes.
Duties will include the following:
· Following defined processes for an assigned panel of members , the LPN will conduct telephonic outreach to assist members with scheduling appointments and services as defined by the follow up protocols. The protocols are developed by the RN supervisor and approved by the practicing Physician to ensure he appropriate level of care and treatment for diagnosis is provided.
· Monitoring patient visits/stays in the Emergency Department, Observation, Inpatient and Swing bed and deliver the member education and coordination of follow up services as defined in the discharge plan.
· Screen members using defined criteria for potential eligibility for chronic care and disease management which is aimed to reduce unplanned utilization of resources
· Review HEDIS measure criteria for each member, obtain orders for any open gaps and coordinate gap closure for the member, ensure appropriate documentation showing the gap is closed
· Review EHR documentation to ensure all documented diagnosis and conditions were listed in the problem list for coding. Follow the defined protocol when gaps are identified and work with the provider to close any identified HCC gaps.
· Monitor defined outcomes and report any issues or barriers with the coordination process. Provide patient education, coaching and guidance for condition specific diagnosis using evidence-based resources
Experience, Skills and Education:
Current Mississippi LPN license
Minimum of two years of experience in a clinic, hospital or managed care environment
Prefer experience with case management and utilization management
Critical thinking skills, problem solving skills
Ability to communicate effectively with patients and providers
Experience with electronic EHR systems
Experience with coaching for patients via telephone/video calls
Prefer experience using Motivational Interviewing skills
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
License/Certification:
Location:
Work Location: Remote
