Job Description
Job DescriptionDescription:
Available Schedule: 4/10 schedule, Mon - Fri , rotated for coverage
About Path of Life Ministries
Path of Life Ministries is a 501c3 organization serving those experiencing homelessness in the greater Riverside area. Our strategy is to provide a holistic system of care in an integrated, seamless manner to individuals and families, leading them from a place of crisis to a life of stability and self-sufficiency. Our goal is to walk people home. We seek talented and compassionate individuals able to thrive in a high-capacity and complex landscape of providing human services in a non-profit setting.
Position Overview
The ECM Licensed Vocational Nurse (LVN) facilitates patient continuity of care with the ECM healthcare team and managed care plan. Under the clinical direction and oversight of the ECM Program Supervisor, RN, the LVN coordinates care for patients needing support by collaborating with the patient, family, physician, nurses, and other members of the ECM healthcare team to identify needs and expedite valuable, appropriate, and cost-effective care.
The LVN will support an individualized care plan focused on disease management and prevention, and or development of improved strategies to benefit patients at risk. They will engage patients and encourage them to take an active role in their health by providing the tools necessary to make healthy lifestyle choices, adopt lifelong healthy behaviors, close care gaps, and reduce unnecessary ER utilization and hospital readmissions.
The ECM Licensed Vocational Nurse (LVN) fulfills their role through a respectful, compassionate, and hopeful style, guided by the company’s values of integrity, excellence, dignity, and accountability.
Essential Functions
- Licensed Vocational Nurse (LVN) requires clinical oversight to be provided by a registered nurse, or licensed BH clinician for some activities.
- The LVN is primarily responsible for working with a caseload of members with medical arid behavior needs, a combination of tier 1-3 members as defined in Risk Grouping-Initial Tiering.
- Gathers information to complete all assessments needed and to incorporate assessment outcomes with members' health need goals.
- Engages members and supports/encourages member activation towards achievement of health goals.
- Responsible for promoting a collaborative and effective working environment within ECM by engaging evidence-based communication strategies (such as motivational interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on member case discussions.
- Tracks medical and behavioral health outcome measures in the web-based care management platform.
- Provides member and family education about chronic medical and behavioral health conditions to improve health literacy.
- Assist the license practitioner to prioritize member cases for systematic population/caseload review.
- Assist the license practitioner in communicating recommendations across the health care team.
- Assist the license practitioner with team-based case reviews.
- Works with members to identify health/wellness goals and incorporates these goals into health action plans/shared care plans that facilitate communication among members and providers.
- Champions healthy lifestyle changes.
- Under the supervision of the team's license practitioner, coordinates physical care management and care coordination relationships with external healthcare providers.
- Highlights treatment follow-up and medication alerts to the team's license practitioner.
- Compile members' medication list.
- Ensures smooth transitions of care, coordination for members that are transitioning from one care setting to another.
- Assist the license practitioner to track and ensure all required screening, assessments, and shared care plan are completed within the set timeframe to avoid non-compliance.
- Monitors CHAs for sign off by the team's license practitioner upon completion by other care team members.
- Review clinical measures report and Healthcare Effectiveness Data and Information Set (HEDIS) outcome measures to address care gaps.
- Monitors CHAs for sign off by the team’s license practitioner upon completion by other care team members.
- Participate in care team meetings to share information.
- Participate in mandatory partner meetings, or internal POLM meetings.
- Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards, including IEHP requirements.
- Embodies the highest ethic with members, including confidentiality, serving all individuals in honoring ways, awareness of trauma informed care for those experiencing homelessness.
- Perform other duties as assigned.
NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.
Path of Life Ministries is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.
Requirements:
Education and Qualifications
- Possession of a valid California Vocational Nurse's License issued by the California Board of Vocational Nurse and Psychiatric Technician Examiners required.
- Minimum one year of successful experience as an LVN, preferably in a public health clinic environment.
- Minimum one year care management experience.
- Willingness & ability to interact with healthcare personnel within a variety of clinical settings.
- Understanding of HIPAA, Confidentiality Obligations, and nursing best practice.
- Ability to review clinical data to address care opportunities and healthcare utilization trends
- Critical thinking skills & able to adapt to a fast, complex working environment.
- Strong autonomous problem-solving ability.
- Excellent time management skills.
- Multitasking and prioritization, working in a high-volume environment with minimal supervision.
- Ability to undertake a variety of diverse care tasks and work in a multidisciplinary team.
- Documentation accuracy in medical records.
- Excellent relational skills.
- Excellent communication skills.
- Excellent problem solving and conflict resolution skills.
- Thrives in a collaborative environment.
- Ability to work with a diverse population of people experiencing homelessness.
- Bilingual (English/Spanish) preferred.
- Travel to patient homes and community settings is required.
- Use of personal vehicle to travel to scattered sites throughout Riverside County and transport patients is required.
- Current CA Driver’s License, proof of Automobile insurance, and a clean driving record required.
Work Schedule Requirements
- Work schedules are subject to change or start and end times may vary based on business needs and operational requirements.
- Flexibility and adaptability are essential to meet the demands of the role and the organization.
Physical & Mental Demands
- Ability to multi-task and stay focused with many interruptions.
- Ability to stay composed in difficult situations.
- Lifting and carrying up to 25 lbs. for short distances.