Job Description
DescriptionSummary:
Provides care under the direct supervision of the Population Health Director of
Care Management or Nurse Manager utilizing physician approved patient protocols according to
established standards and best practice guidelines. Facilitates the communication between
patient/caregiver, physician and the outpatient care team to optimize health and wellness, reduce
inpatient admission, reduce re-admissions and improve medical stability in the patient population
served. Works collaboratively with Nurse Navigators to manage medical stability in patients with
high risk disease management with complex comorbid conditions.
Responsibilities: Manages a case
load of 10,000-15,000 patients with identified gaps in care in collaboration with the Health Care
Team.Works in collaboration with the PCMH Team in the design, implementation and evaluation of the
PMH model as applicable.Works proactively to coordinate preventative/follow-up care for all patients
receiving care from participating providers.Reviews patient medical record to identify care
gaps.Schedules needed preventative services using evidenced based Physician approved protocols and
documents the encounter.Fosters a Team approach by working collaboratively with the member, family,
PCP and other members of the healthcare team to ensure coordination of services.Assists Nurse
Navigators’ in performing transition of care outreach to discharged patients to schedule return
visit with the PCP per guidelines.Employs knowledge of evidenced based guidelines to effectively
communicate the importance of recommended procedures and testing.Facilitates a collaborative
approach with care team for identification of and closure of care gaps.Utilizes educational and
behavioral change strategies to promote patient collaboration with the care team.Incorporates
excellent written, verbal and listening communication skills, positive relationship building skills
and problem solving into patient care coordination practice.Performs duties as required or assigned
for specific operational purposes for which they are qualified to perform.Maintains all professional
CEU’s in compliance with State and Regulatory requirements.Maintains confidentiality in all areas at
all times.
Requirements:
LVN License in state of employment or compact
Work Type:
Full
Time
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Additional Information:
- Specialty: LPN
- Location: 5101 North O Connor BoulevardIrving, Texas 75039
- Contact:
About the Company:
CHRISTUS Health is an international Catholic, faith-based, not-for-profit health system comprised of
more than 600 services and facilities, including more than 60 hospitals and long-term care
facilities, 350 clinics and outpatient centers, and dozens of other health ministries and
ventures.
Sponsored by the Sisters of Charity of the Incarnate Word in Houston and San Antonio and
the Sisters of the Holy Family of Nazareth, the mission of CHRISTUS Health is to extend the healing
ministry of Jesus Christ.
To support our healthcare ministry, CHRISTUS Health employs approximately
45,000 Associates and has more than 15,000 physicians on staff who provide care and support for
patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United
States.
EXTENDING THE HEALING MINISTRY OF JESUS CHRIST
We are inspired by our mission, vision and
core values to deliver compassionate, high quality health care, improving the health of the
communities we serve. Above all, we are committed to providing our customers and their family
members with a truly unique healing experience, one that embodies our values and respects the
dignity and worth of each person. Creating a health care system that is truly excellent in all areas
is an ongoing effort.