LPN Case Manager

The Licensed Vocational Nurse (LVN/LPN) Case Manager supports the Transitions of Care program by assisting the RN Care Manager in implementing patient care plans to reduce 30-day hospital readmission rates. This role involves appointment scheduling, biometric monitoring, patient education, home and office visits, and connecting patients with community resources. The LVN/LPN works as part of a multidisciplinary team, maintains frequent patient contact, documents care in the EHR, and manages a caseload of approximately 25 30 patients. This is a mobile position requiring travel and strong communication skills, with an emphasis on adult and geriatric populations. Responsibilities:

• Assist RN Care Manager in implementing individualized care plans.
• Schedule patient appointments and monitor biometric data.
• Provide and reinforce patient education on health management.
• Attend patient visits and conduct home visits as needed.
• Connect patients with appropriate community resources and support services.
• Maintain frequent contact with patients to monitor progress and barriers.
• Document patient interactions and care activities accurately in the electronic health record (EHR).
• Participate in multidisciplinary care team rounds to provide patient updates.
• Manage a rolling monthly caseload of approximately 25 30 patients.
• Collaborate with social workers, pharmacists, and other healthcare professionals as part of the care team.

• Current and active Licensed Vocational Nurse (LPN/LVN) license in the state of practice.
• Basic Life Support (BLS) certification.
• Minimum of 1 year experience in home health, mobile case management, or related nursing field.
• Strong clinical knowledge, preferably including experience with CHF, COPD, and complex comorbidities.
• Excellent communication and documentation skills.
• Ability to work independently and manage a caseload effectively.
• Reliable transportation and valid driver's license for travel to patient homes, hospitals, and provider offices.

• Experience with care coordination and community resource linkage.
• Familiarity with transitions of care programs and reducing hospital readmissions.
• Prior experience working in adult and geriatric patient populations.
• Comfort with telephonic patient follow-up and remote care management.

• This is a mobile position requiring travel to patient homes, hospitals, and provider offices.
• Role is non-hands-on nursing; no direct patient care such as medication administration or invasive procedures.
• Participation in virtual multidisciplinary care team rounds is required.
• Must be flexible and able to adapt to changing schedules and patient needs throughout the day.

• Full-time position, Monday through Friday, 8:00 a.m. to 4:30 p.m.
• 40 hours per week guaranteed.
• No weekend or holiday shifts required.
• Floating between multiple locations including hospitals, patient homes, and provider offices.