Licensed Professional Nurse (LVN) CCM/RPM Care Coordinator

About IntraCare

IntraCare Health Center (DFW Healthcare MSO) proudly serves the greater Dallas-Ft. Worth and Phoenix, Arizona areas with a decade of excellence in value-based care and clinic operations. Our outstanding leadership and commitment to service have established us as a trusted partner for multiple healthcare organizations.

At IntraCare, we believe in more than just a job; we offer a vibrant workplace where culture and collaboration thrive. We are dedicated to fostering an inclusive environment that values diverse perspectives and promotes respectful dialogue. Our approach encourages innovation and healthy debate, as we seek to build a team of dedicated partners who contribute to our collective success. We are passionate about empowering our employees, helping them grow both personally and professionally. This unwavering focus on team culture and individual development is the cornerstone of our ongoing achievements.

About the role

We are seeking a compassionate and skilled Chronic Care Management/Remote Patient Monitoring (CCM/RPM) LVN Care Coordinator to join our team. This hybrid role involves both remote and in-office responsibilities (minimum in office/travel within the Phoenix marketplace 2 days per week with some weeks requiring more travel within the market), and you will play a crucial role in managing patient relationships, monitoring health conditions, and ensuring patients receive the necessary support to manage their chronic diseases effectively. 

What you'll do

Key Responsibilities:

• Serve as the primary point of contact for patients enrolled in the CCM/RPM program.
• Monitor patient data and follow up regularly to ensure adherence to care plans.
• Communicate with patients via phone to address their needs and meet program requirements.
• Collaborate with healthcare providers to ensure appropriate patient care.
• Document patient interactions and progress in the electronic health record (EHR) system.
• Provide support and guidance to patients on managing chronic conditions.
• Connect patients with available social resources to address their healthcare needs.
• Monitor patient progress and ensure timely interventions when necessary.
• Assist in developing and implementing care plans for chronic disease management.
• Provide training to unlicensed professionals and support care coordinators on CCM/RPM protocols and best practices.
• Conduct regular provider meetings to review patient cases, discuss enrollments, and ensure effective communication.
• Maintain relationships between the CCM/RPM team and provider practices.
• Ensure compliance with all regulatory and organizational standards.

Qualifications

• LVN license in Texas, or ability to obtain a license in Arizona within 30 days of being hired.
• Minimum of 3 years of experience in chronic care management or remote patient monitoring.
• Strong knowledge of chronic disease management program requirements.
• Excellent communication and organizational skills.
• Willingness to travel to home office or clinic locations regularly to support program success.