Lpn Case Manager

Job Summary:

The Licensed Vocational Nurse (LVN/LPN) Case Manager supports the Transitions of Care program by assisting the RN Care Manager in implementing care plans aimed at reducing 30-day hospital readmission rates. This role involves appointment scheduling, biometric data monitoring, patient education, home and office visits, and connecting patients with community resources. The LVN/LPN works as part of a multidisciplinary team, maintaining frequent patient contact and documenting in the electronic health record. This position requires strong communication skills, the ability to work independently, and reliable transportation for travel to patient homes, hospitals, and provider offices.

• Assist RN Care Manager in implementing patient care plans.
• Schedule patient appointments and monitor biometric data.
• Provide and reinforce patient education regarding treatment and medication adherence.
• Conduct home visits and attend patient office or hospital visits as needed.
• Connect patients with community resources to support care goals.
• Maintain frequent contact with patients to monitor progress and barriers.
• Document patient interactions and care activities accurately in the electronic health record.
• Participate in multidisciplinary care team rounds to provide patient updates.
• Manage a monthly caseload of approximately 25 30 patients.
• Work collaboratively with social workers, pharmacists, and other team members.

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

• Experience with care coordination and community resource linkage.
• Familiarity with electronic health record (EHR) systems.
• Experience working within a multidisciplinary care team.

• This is a mobile position requiring travel to patient homes, hospitals, and provider offices.
• Role is non hands-on nursing; no direct patient care requiring physical nursing procedures.
• Participation in virtual care team rounds and telephonic patient follow-up is required.
• Must be flexible to adapt to changing patient needs and schedules throughout the day.

• Full-time position with a Monday through Friday schedule.
• Standard work hours are 8:00 a.m. to 4:30 p.m.
• No weekend shifts or on-call requirements specified.