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Licensed Practical Nurse

Company: Upward Health
Location: Hauppauge
Posted on: May 3, 2022

Job Description:

Licensed Practical Nurse The Licensed Practical Nurse is responsible for the care of an assigned cohort of high-risk, high-need patients, as well as the implementation and ongoing monitoring of care plans and outcomes for those patients as set forth by the physician's plan of treatment. This role will demonstrate a commitment to effective and efficient care leading to high quality outcomes, while managing the total cost of care. The focus is to deliver care in the home, or the most optimal level of safe and effective site of care. Why is this role critical? The Licensed Practical Nurse acts as a liaison between patients, their families, doctors, and ancillary health care providers ensuring the patient, family and caregivers understand the care plan and can progress towards self-care wherever possible. The Licensed Practical Nurse will serve in a direct care and patient advocacy role and will ensure interdisciplinary care is optimized toward targeted outcomes. This colleague works directly with the patient in the field, i.e., inpatient bedside, member's home, provider's office, hospitals, and other sites of care while collaborating with the Clinical Services team to assess, plan, implement, coordinate, monitor and evaluate services and outcomes to maximize the health of the patient. Responsibilities: -- Support the physician's assessment and evaluation of individual patients and deliver care services to support desired patient outcomes -- Provide for the ongoing monitoring and delivery of patient care that results in optimized quality, clinical and financial outcomes -- Under the supervision of a Physician or Registered Nurse, complete comprehensive assessments and support the plan of care utilizing clinical expertise to evaluate the patients need for additional services -- Develop a relationship of safety and trust with transparent communication between the patient, caregivers, and the care team -- Identify, acknowledge, and advocate for the needs of the patient -- Support the patient-centric care plan and environment that incorporates the needs of the patient -- Review the patient diagnoses and facilitates the coordination of treatment plans of the PCP, specialists, and interdisciplinary care team -- Evaluate patient outcomes with respect to the medical record, patient and family history and available healthcare utilization information -- Continuously monitor and update care plans and coordinate care across providers -- Educate patients and families about treatment plans and options -- Accurately document and submit medical documentation -- Maintain knowledge of diagnoses, signs and symptoms of disease, standard therapy protocols derived from evidence-based outcomes, medications, and warning signs of non-optimal patient outcomes -- Provide guidance and support to patients and families inclusive of community-based support programs -- Review results from medical tests and ensure visibility across all care providers -- Implement physician orders - ensuring a linkage between all care providers throughout a patient's episodes of care -- Communicate patient progress by conducting regular interdisciplinary meetings and evaluations, disseminating results and obstacles to the healthcare team and family -- Act as a resource for non-clinical staff -- Coordinate community resources, with emphasis on medical, behavioral, and social services. -- Apply case management standards, maintains HIPAA standards and confidentiality of protected health information, and reports critical incidents and information regarding quality-of-care issues -- Meet with patients in their homes, worksites, physician's offices, or hospital to provide management of services. -- Participate with other care team members in regular or special meetings such as Clinical rounds -- Utilizes clinical skills and abilities to support the monitoring of patient vital signs with utilization of remote patient monitoring tools as required by the physician -- Supports the provision of care through Facilitated Virtual Care (FVC) visits -- Perform other duties as assigned Required Qualifications -- Unrestricted licensed practical nursing license in the state(s) of care management activities -- Ability to travel to patient's home, provider's office, hospitals, other healthcare settings required with dependable car -- Experience in home care, outpatient, or physician office site of care provisioning patient care under a practicing medical physician and/or registered nurse -- Must be willing to spend 80% of time traveling in the field -- Demonstrated expertise in care coordination across all healthcare providers, patient, and caregivers -- Experience with completing accurate, real-time documentation in EHR and/or Care Management systems -- Ability to effectively communicate across a multitude of key care partners -- Ability to motivate patients and caregivers to follow care plans and optimize self-care potential -- Excellent documentation skills with the ability to manage multiple patient cases -- Sound critical thinking and problem-solving skills to assess, analyze and monitor outcomes to support patient's plan of care -- Computer literacy and ability to effectively communicate within the business structure Preferred Qualifications -- 3+ years of care management experience in an outpatient setting preferred -- 3+ years in a hospital or related healthcare business entity also considered -- Experience serving the Medicare population -- Experience documenting in Electronic Health Records (EHR) -- Proven experience working independently seeing patients in the community Job Type: Full-time Employment Type: Full Time Years Experience: 1 - 3 years Bonus/Commission: No

Keywords: Upward Health, Westport , Licensed Practical Nurse, Healthcare , Hauppauge, Connecticut

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