Complex Care Management LPN

About the Role

We are seeking a compassionate and detail-oriented Complex Care Management LPN to join the Care Management team at Cornell Scott–Hill Health Center. In this role, the LPN will support patients and clients by assisting with both direct and indirect care management services to address a wide range of healthcare and social service needs.The Complex Care Management LPN will collaborate closely with Medical Providers, Behavioral Health Providers, Complex Care Managers, and other interdisciplinary team members to provide clinical support services, care coordination, and data management. Responsibilities include assisting clients with referrals and follow-up care, entitlement and housing resources, collection and documentation of client information, and providing administrative and clerical support to the care management team as needed.

• Key Responsibilities
• Assists in the development of a comprehensive complex care management plan, with particular emphasis on medically complex issues.
• Works with patient/caregiver/co-learner to develop goals, informs care team if inappropriate for complex care and makes recommendation for care plan in usual care teams.
• Provides clinical support and direct care management including patient education, goal setting, self-management teaching and coaching for the high risk patients.
• Interacts with patients and patient caregivers as appropriate to ensure continuity of care, patient adherence to care plans, and identification of barriers preventing adherence to care plan.
• Works with care management team to identify client/patient need for advocacy in the area of accessing health and behavioral health systems and services, entitlements and community resources.
• Documents and communications clients need to care management team.
• Performs all other duties as required.

• Required Qualifications
• LPN Graduate from an accredited school. Must have a current Connecticut State Licensure.
• Minimum of five (5) years of experience in a long-term care facility or rehabilitation center. Clinic experience is highly desirable.
• Excellent Patient Management skills.
• Must be strongly motivated and able to accept supervision.
• Computer skills are essential with the ability to learn AS400, SRS, MDLink and Mednexus.