LPN Care Coordinator: Transition & Chronic Disease

JumpStart Games; Lakeland (FL); On-site; USD 42,000 - 62,000; Full time

Job summary

Watson Clinic seeks an LPN Care Coordinator to manage patients with complex needs, focusing on transition of care, chronic disease management, and care planning. The role supports the Value Based Services team, collaborating with care teams and patients to deliver efficient, high-quality care to the community.

The ideal candidate has an LPN license in Florida, 2 years’ inpatient/ambulatory experience, and strong Excel skills for data-oriented coordination.

Qualifications

• Graduate of an accredited Licensed Practical Nurse program.
• Florida licensure required.
• Two years’ experience working in both inpatient and ambulatory care settings.
• Proficiency with Excel.
• Excellent listening and interpersonal skills.
• Ability to maintain confidences and handle multiple tasks simultaneously.
• Flexible, resourceful and able to problem solve.

Responsibilities

• Identify patients for inclusion in program utilizing available metrics.
• Identify and reduce barriers to care utilizing health plan services and community resources.
• Perform comprehensive patient assessments on entry and periodically with focus on support systems and needs.
• Contact patients telephonically for care coordination and medication reconciliation post-discharge.
• Assist patients in gaining access to PCP and specialist appointments as needed.
• Educate patients on disease management and promote self-management.
• Follow up on DME needs and home health agency issues.
• Develop and implement individualized, goal-driven care plans.
• Assist patient and family navigation of their health care plan.
• Monitor progress toward goals and revise plans as needed.
• Document encounters and discussions in the EHR.
• Conduct home, hospital and clinic visits per guidelines.

Skills

Interpersonal skills

Telephone communication

Problem solving

Multitasking

Education

Licensed Practical Nurse (LPN)

Bachelor’s degree (preferred)

Case Management Certification (preferred)

Tools

Excel

Microsoft Word

Job description

Watson Clinic seeks an LPN Care Coordinator to manage patients with complex needs, focusing on transition of care, chronic disease management, and care planning. The role supports the Value Based Services team, collaborating with care teams and patients to deliver efficient, high-quality care to the community.

The ideal candidate has an LPN license in Florida, 2 years’ inpatient/ambulatory experience, and strong Excel skills for data-oriented coordination.