Member Care Coordinator- LPN

POSITION SUMMARY:The LPN 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 LPN assigned to a panel of participants based on stratification and disease model, coordinates 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. Panel of participants assigned to LPNs includes strat 1 through 3 participants for the diabetes, cardiac, respiratory programs and strat 1 through 4 participants for impact condition programs. The LPN utilizes indicators for potential risk to identify participants for referral to an RN for assessment for increasing acuity. Those participants are subsequently assigned to a RN on the disease management team. LPN is supervised by an LCM (Leader Care Manager), who is an RN. All Healthways clinicians (including the LPN) are required to participate in the orientation and to take the pre and post tests to review competency during orientation. Yearly competency test is required for all Healthways clinicians.RESPONSIBILITIES INCLUDE:1. Achievement of Clinical Objectives:A. Delivers services to strat 1 through 3 participants for the diabetes, cardiac, respiratory programs and strat 1 through 4 participants for impact condition programs. LPN colleagues can take inbound calls within their scope and will transfer the call to an appropriate team member as needed. B. Reviews status of participant’s preventive health exams as defined by the disease-specific Standards of Care guidelines. Initiate appropriate interventions for member. C. Contacts participant by telephone as needed for information sharing and intervention not requiring expertise of a Registered Nurse.D. Identifies educational needs of participant and facilitate educational opportunities (i.e. mails patient education materials; refer to health plan if appropriate). E. Identifies participant barriers to accessing health care services. Coordinates with Provider Service Managers and/or other members of the disease management program team to remove system barriers. F. Functions as integral part of the multi-disciplinary team. Facilitates communication exchange with primary managing physician and other providers, health plan, and the disease management program team.G. Coordinates with other colleagues to ensure continuity of care for assigned member panel to avoid gaps in care or call campaigns. 2. Performance of information gathering responsibilities:A. Gathers and documents data under “assessment” module of the Clinical Information System (CIS), consistent with stratification matrix model and guidelines. Participates and collaborates with registered nurses in the identification of member needs through documentation of this health information. B. Transfers participant to a RN when determined as appropriate following the “Requirements for Transfer of Call from non-RN care team professional to an RN” procedure under Care Team Delivery Model (CTDM) policy.C. Collects additional information from primary managing physician, the participant and other members of the disease management team as needed to evaluate for appropriate intervention and possible re-stratification. D. 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 participant 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 LPN license appropriate for the state in which the program is located.2. 1-2 years Minimum 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 participants, 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. 10. Counseling/Teaching Skills: ability to effectively educate people in a telephonic environment utilizing and promoting adult learning.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.SUPERVISORY REPSONSIBILITES:This position has no supervisory responsibilities.CRITERIA FOR PERFORMANCE EVALUATION:Performance evaluation will be based on the LPN’s abilities in meeting the criteria outlined herein; contributing to meeting the goals and accomplishments of the disease management system and of Healthways, Inc. To ensure quality of care, monthly chart audits and CDP (Colleague Development Process) are completed by their LCM (Leader Care Manager) who is an RN.POSITION REPORTS TO:Leader Care ManagerJOB DESCRIPTION STATUS:The duties and responsibilities listed in this job description are illustrative ones anticipated for this position. Other duties and responsibilities may be assigned, as required. Healthways, Inc. reserves the right to amend or change this job description to meet the needs of its program. This job description and any attachments do not constitute or represent a contract.We offer our colleagues: -formalized ongoing training and education, including a 3-week comprehensive training program -Set work schedules, Monday-Friday, with limited Saturday coverage (closed Sundays and holidays) -Part time shift opportunities, 4-5 evenings per week from 2:00pm-8:30pm, 3:00pm-9:30pm. Start times may vary. No Saturdays if working Monday-Friday evenings. -Leverage your clinical, problem-solving skills to improve the lives of others. -Competitive salary and excellent benefit options (health insurance, dental, vision, life, 401(k) with company matching, tuition reimbursement and paid vacations). Benefit eligible at 30 hours per week. Please apply online at www.healthways.com LPN