LVN-Member Care Coordinator

POSITION SUMMARY:The LVN Member Care Coordinator has the responsibility for supporting the goals and objectives of the care enhancement program by interacting with members in an appropriate, efficient and cost effective manner while ensuring high quality care. The LVN has responsibility for a panel of members, as identified through the stratification model, coordinating with the Primary Care Provider and all other members of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The LVN is also responsible for early identification of those assigned members who are at risk for increasing acuity. RESPONSIBILITIES INCLUDE:1. Achievement of Clinical Objectives:A. Monitor member's preventive health exams as defined by the disease-specific Standards of Care guidelines. Initiate appropriate non-assessment interventions for members. B. Contact members by telephone as needed for information sharing and intervention not requiring expertise of Member Care Manager or Comprehensive Care Manager. C. Identify educational needs of member and facilitate educational opportunities (i.e. mail supplemental education topics; refer to health plan if appropriate). D. Identify member barriers to accessing health care services. Coordinate with Provider Service Manager and/or other members of the disease management program team to remove system barriers. E. Function as integral part of the multi-disciplinary team. Facilitate communication exchange with primary managing physician and other providers, health plan, and the disease management program team.F. Coordinates with other colleagues to ensure for continuity of care for assigned member panel when involved in other activities or away from the office. 2. Performance of information gathering responsibilities:A. Gathers and documents data consistent with stratification matrix model and guidelines. Participates and collaborates with registered nurses in the assessment and evaluation of member needs. B. Collects additional information from primary managing physician, the member and other members of the disease management team as needed to evaluate for appropriate intervention and possible re-stratification. C. Coordinates information exchange with the primary managing physician, health plan, other providers and members of the disease management team.OVERALL QUALIFICATIONS:This position requires a responsive, committed individual who recognizes the impact of the health care delivery system on the clinical and financial outcomes of the member population and can identify and take action to facilitate system improvements.The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. QUALIFICATIONS: 1. Current LVN license appropriate for the state in which the program is located.2. Minimum 1-year recent experience in a clinical setting.3. Ability to be self-directed, highly organized and proactive.4. Basic knowledge of physiology and chronic disease appropriate for licensure. 5. Excellent listening skills.6. Language Skills: Ability to communicate with members, other members of the team, physicians, and plan representatives. Effective oral and written communication skills. Ability to read, analyze, and interpret common scientific and technical journals. Ability to effectively present information to audiences with a variety of knowledge/skill levels.7. Math Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, percent and to draw and interpret bar graphs. 8. Reasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exits. Ability to interpret and organize data in an effective and useful manner; ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. 9. Computer Skills: To perform this job successfully, an individual should have basic computer skills and be familiar with a Windows operating system. LICENSES/CERTIFICATIONSCurrent LPN license appropriate for the state in which the CEC is located.PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by a colleague to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the colleague is required to sit for long periods at a time; type using a computer keyboard; visually read information off of a computer monitor; talk hear and orally communicate information over the telephone. Specific vision abilities required by the job include close vision and color vision and the ability to adjust focus.WORK ENVIRONMENT:Work environment characteristics described here are representative of those that must be met by a colleague to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the colleague could be exposed to outdoor weather conditions prevalent at the time. The noise level may vary from light to moderate depending on the location.LPN