CCM LPN Nurse: Chronic Care Coordinator

Northwest-Florida-Community-Hospital; Chipley (FL); On-site; USD 48,000 - 60,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

PTO

401(k) retirement plan with employer

Life insurance

Disability benefits

Employee assistance and wellness

Continuing education and professional

Certification incentive pay

Stable full-time day shift

Growth opportunities

Job summary

Northwest Florida Community Hospital is seeking a full-time Licensed Practical Nurse (LPN) to join our Medical Clinics team in a Chronic Care Management (CCM) role. The CCM LPN will work closely with providers to coordinate care for patients with chronic conditions, focusing on outreach, education, follow-up, and care coordination to help patients manage their health and maintain continuity of care.

The role involves routine outreach, developing care plans, patient education, medication reviews,

Qualifications

• Current Florida LPN license in good standing.
• Graduate of an approved practical nursing program.
• Current BLS certification.
• Previous medical clinic, primary care, chronic care management, or care coordination experience preferred.
• Strong communication, organization, and documentation skills.
• Comfortable communicating with patients by telephone and working with electronic medical records.

Responsibilities

• Conduct routine outreach and follow-up with patients enrolled in Chronic Care Management.
• Assist with developing and maintaining individualized patient care plans.
• Educate patients on chronic conditions, medications, treatment plans, and provider recommendations.
• Review medications with patients and communicate concerns or discrepancies to the provider.
• Monitor patient-reported symptoms and promptly communicate changes in condition to the appropriate provider.
• Coordinate referrals, specialist appointments, testing, and follow-up care.
• Assist with transitions of care following hospitalizations, ER visits, and other encounters.
• Communicate with providers, pharmacies, specialists, hospitals, and other members of the patient’s healthcare team.
• Review patient records for outstanding testing, referrals, appointments, and preventive care needs.
• Document patient communication, care coordination activities, and CCM services in EMR.
• Maintain tracking of CCM activities and time for billing and compliance purposes.
• Maintain patient confidentiality in line with HIPAA.

Skills

LPN license (FL)

BLS certification

Clinic experience

Communication skills

EMR/documentation

Independent with teamwork

Education

Approved practical nursing program

Tools

EMR systems

Job description

Northwest Florida Community Hospital is seeking a full-time Licensed Practical Nurse (LPN) to join our Medical Clinics team in a Chronic Care Management (CCM) role. The CCM LPN will work closely with providers to coordinate care for patients with chronic conditions, focusing on outreach, education, follow-up, and care coordination to help patients manage their health and maintain continuity of care.

The role involves routine outreach, developing care plans, patient education, medication reviews,