Care Manager LPN

Carolina Health Centers•Greenwood, SC

7d•Remote

About The Position

The Care Manager is responsible for coordinating and delivering care management and related care coordination services for patients with multiple chronic conditions. This position focuses on building trusting relationships with patients, developing individualized care plans, and collaborating with the patient’s care team to improve health outcomes, reduce avoidable hospitalizations, and enhance patient engagement. The role is primarily remote, using phone, electronic health record (EHR) tools, and telehealth platforms to provide services.

Requirements

Graduate of an accredited School of Nursing
Current, unrestricted Licensed Practical Nurse License in South Carolina or a compact state.
Minimum 2 years of nursing experience, preferably in primary care, care management, case management, or chronic disease management.
Able to read, write and communicate effectively orally and in writing
Proficient in use of computer and keyboard
Proficiency in using electronic health records (EPIC preferred)
Able to establish and maintain effective working relationships
Excellent interpersonal and communication abilities
Strong communication skills and ability to build rapport with patients remotely.
Ability to work independently, manage time effectively, and prioritize patient needs.
Knowledge of CMS CCM billing guidelines and documentation standards.
Experience with telehealth, remote patient monitoring, or population health programs.
Have the hand-eye coordination and manual dexterity needed to operate a computer, telephone, copier, standard office equipment, and medical equipment.
Required to talk and have a normal range of hearing and eyesight to be able to collect data and record where appropriate (i.e. computer and/or paper).
Vision abilities required for this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus

Responsibilities

Provide monthly care management services for assigned patients in accordance with CMS guidelines.
Perform comprehensive assessments, including medical, social, functional, and behavioral health needs.
Develop, implement, and update patient-centered care plans with input from patients, families, and providers.
Conduct monthly billable check-ins, track cumulative time, and ensure accurate documentation in EHR.
Coordinate care across providers, specialists, hospitals, and community resources.
Support Remote Patient Monitoring (RPM) initiatives by reviewing data, identifying trends, and intervening as needed.
Provide health coaching and patient education related to chronic disease management.
Monitor and address care gaps, preventative screenings, and medication adherence.
Identify and escalate high-risk patients for provider review.
Maintain accurate, timely, and compliant documentation of all patient interactions.
Participate in quality improvement initiatives related to care management and population health.