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High Risk Care Coordinator

Oasis Health Partners®
  • US
    New York, New York, United States
  • US
    New York, New York, United States

À propos

High Risk Care Coordinator Remote You are a Licensed Practical Nurse (LPN) who thrives on connecting with people through compassionate communication. You easily build meaningful relationships and support positive behavior change through partnership rather than pressure. Leveraging your practical nursing knowledge and structured care protocols, you help patients clearly understand and follow their provider-directed care plans. You bring grace under pressure and feel energized by supporting high-risk patients as they work toward improved health and stability. Oasis Health Partners (Oasis) is building healthier communities by advancing primary care. We partner with patients, providers and plans to provide personalized, local care for seniors in towns across America. We believe that patients' needs come first, and that primary care is the foundation of patient-centric healthcare. With Oasis, patients receive better access and care. Providers receive the data, resources and expertise to be successful in value-based care arrangements. Payors get the benefit of a solution that improves performance, drives growth and reduces the total cost of care in hard-to-engage markets. Together, we will boldly advance primary care for those that need it most. We are excited for you to join us on this journey. We invite you to be a part of Oasis, where you'll discover we listen first, do the right thing, build things together and go all in --- while having fun! As a High-Risk Care Coordinator, you build trusted, ongoing relationships with high-risk patients through consistent outreach, active listening, and structured clinical support. You regularly engage patients by phone and text to address complex medical and social needs, including medication management, chronic condition monitoring, and barriers to care. Using patient-centered discussion and established care protocols, you support patients in understanding and adhering to provider-directed care plans while identifying emerging risks that require escalation. This role is part of a new high-risk patient management program being built from the ground up. You will have the opportunity to help shape workflows, outreach strategies, and processes that truly work for patients and care teams. Additional Responsibilities:
Conduct regularly scheduled outbound outreach to high-risk patients to support ongoing care management, reduce avoidable utilization, and address gaps in care. Contribute to the development of a new high-risk patient management program by helping design, test, and refine outreach workflows, documentation practices, and care coordination processes in a growing, non–enterprise EHR environment. Perform medication reconciliation and adherence support by reviewing patient-reported medication use, identifying discrepancies, and escalating concerns to the RN or Provider. Collect, assess, and document patient-reported symptoms, condition trends, risk indicators, and barriers to adherence within LPN scope of practice. Provide disease-specific education, self-management reinforcement, and motivational coaching using approved materials and care pathways. Coordinate home health services and durable medical equipment (DME) needs under RN or Provider direction to support patient safety and stability in the home. Identify and address social determinants of health impacting high-risk patients, including access to medications, transportation, food, housing support, or financial resources. Support coordination and monitoring for patients with complex chronic conditions, including COPD, CHF, diabetes, and hypertension, using established protocols. Serve as a consistent point-of-contact for assigned high-risk patient panels, building trusted relationships that promote sustained engagement and accountability. Recognize changes in patient status, emerging risks, or non-adherence patterns and escalate promptly through defined clinical pathways. Provide feedback to Clinical Operations and Clinical Leadership to support continuous improvement of high-risk patient management programs.
Investment In Our Team We invest in the personal and professional success of our team. We take care of our people and offer robust benefits including medical, dental, vision and generous time off plans. We are committed to supporting your growth with a development program that starts with onboarding and continues throughout your career. As an inclusive, passionate and diverse team, you will partner with professionals who understand the importance of high-value, high-impact patient care. We invite you to be a part of Oasis, where you'll discover we listen first, build things together, always do the right thing, have fun and most importantly, are all in! About You
You have completed an accredited practical nursing (LPN) program, with at least two years of prior nursing experience in care coordination, population health, or chronic disease support Licensed as a Licensed Practical Nurse (LPN) and credentialed in good standing in the applicable state(s) of practice Experience making structured, outbound calls, preferably in a call-center environment, and feel confident engaging patients proactively by phone Experience supporting high-risk patients with chronic conditions, care management, or utilization reduction preferred Comfortable performing medication reconciliation, structured symptom monitoring, and care coordination under RN or provider oversight Experience making structured outbound call calls, preferably in a call-center environment, enjoy and feel confident engaging patients proactively by phone Strong patient communication skills, including the ability to engage, motivate, and support patients using patient-centered techniques Compassionate communicator with strong active listening abilities Highly organized, dependable, and emotionally intelligent, with the ability to manage ongoing patient panels Proficient in EHR documentation and care management or population health tracking tools Able to multitask effectively in a fast-paced outreach environment with strong time management and follow-through skills
Hourly Pay Range $33.65 - $48.08 USD The posted salary range reflects the broader pay range for the level associated with this role. Because the range is designed to support growth over time, starting salaries are typically aligned to a candidate's experience and demonstrated scope relative to the role. At this time, we are unable to sponsor employment visas. Candidates must be authorized to work in the United States without a current or future visa sponsorship. This role is open to applicants currently residing in the United States. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status, or disability status.
  • New York, New York, United States

Compétences linguistiques

  • English
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