As an LPN Care Coordinator, you will play a pivotal role in managing and coordinating care for patients enrolled in Alopex’s services. You will work closely with patients, primary care providers, and other specialists to develop, implement, and monitor individualized care plans. Your goal is to ensure that patients receive the highest level of care through ongoing communication and coordination. Conduct a detailed review of EMR records. Develop and maintain individualized Care Plans for management of patients. Implement and coordinate all care management activities relating to patients across the continuum of care. Communicate with the patient’s clinical care team. Care management must be performed in a timely manner. Monitor patient progress toward desired outcomes through assessment and evaluation. Maintain accurate and detailed documentation related to medication, problems, goals, interventions, preventative care, etc. Conduct monthly care calls to the patients enrolled in the program. Address all needs/concerns including any follow up needed for patients. Educate patients on chronic conditions and reinforce the provider’s directions related to chronic conditions. Evaluate and address social determinants to health and begin to link community resources; then, enter them in the system. Evaluate/assess medical conditions and be able to identify and address changes in a clinically appropriate manner. Adhere to all policies & procedure as outlined by Medicare and Shifox/Alopex Perform other duties as assigned.
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Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed