Patient Care Advocate; LPN

The Well Be care model is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients. This population is typically underserved and very challenged with access to care. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care.

Care is provided throughout the entire continuum of care – from chronic care and urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care. Well Be's physician/advanced practicing clinician led geriatric care teams’ partner with the patient’s primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.

Our Patient Care Advocate (PCA) is an energetic, curious explorer, part of a team that provides compassionate care to the frailest elderly who suffer from chronic and acute illnesses or injuries living in their homes. The PCA is responsible for developing a rapport, delivering exceptional in-home services, coordinating care with the rest of the medical team, scheduling patient appointments with our team, specialist appointments and coordinating diagnostic tests, HEDIS gap closure, acting as a community resource, engaging patients that currently are not engaged, and contributing complete and accurate data in patient records, and other tracking tasks.

The successful candidate will love working with seniors and a collaborative interdisciplinary team. We offer a positive, upbeat work environment where all medical personnel work together for the good of the patient.

• Practices the Well Be mission:
  To help our patients lead healthier, meaningful lives by delivering the most Complete Care.
• Acts as a community resource for the patient
• Completes support during Comprehensive Initial visit when needed.
• Manages patient medical records as appropriate
• Completes Drop in visits for unengaged patients or open HEDIS gaps
• Answers patient non-clinical questions and explains the process
• Ensures all appropriate patient documentation for non-clinical summaries are in the EMR.
• Provides positive customer service and treats all patients and staff with respect
• Collaborates with the interdisciplinary team and participates in regularly scheduled team meetings as directed by supervisor.
• Completes non-invasive patient screenings, and testing.
• Ability to clearly explain POCT to geriatric patients.
• Escalates patient clinical concerns to APP, CD, CMD.
• Supports APP in ongoing panel management and quality of care efforts (e.g., HEDIS)
• Utilizes HEDIS tracking tools, meets and improves HEDIS STARS performance.
• Other tasks needed to accomplish team’s objectives/goals.

• High school graduate or GED

• LPN Certification

• 2+ years of patient-facing experience working for a healthcare practice or hospital
• Current BLS card for healthcare providers or willingness to obtain
• EMR documentation experience preferred
• High level of professionalism
• Strong customer geriatric focus/service skills
• Strong computer skills, including Word, Excel, and Power Point
• Strong verbal, written, presentation, and interpersonal communication skills

Pay Range: $44,000 to $55,000

4 days in field, 1 day in office

Travel is required locally. The role is a field-based role visiting patient homes.

Well Be is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected status.