Licensed Vocational Nurse

Bilingual Chronic Care Coordinator (English/Spanish) – Cardiology Practice

Location: Humble
Employment Type: Full-Time
Department: Primarily cardiovascular

Position Summary

We are seeking a bilingual, compassionate, organized, and detail-oriented Chronic Care Coordinator to join our growing cardiovascular team. The Chronic Care Coordinator plays a vital role in improving patient outcomes by providing ongoing support, education, and care for patients with chronic cardiovascular conditions.

This position serves as a liaison between patients, providers, specialists, and community resources to ensure patients receive comprehensive, high-quality care while meeting Chronic Care Management (CCM) program requirements. This role requires frequent communication with English and Spanish speaking patients.

Essential Duties and Responsibilities

· Enroll eligible patients into the Chronic Care Management (CCM) program and obtain required consents under guidance of board certified physician.

· Conduct monthly patient outreach via telephone to assess health status, identify barriers to care, and provide education.

· Develop, update, and maintain individualized care plans.

· Coordinate care between cardiologists, primary care providers, specialists, hospitals, and other healthcare organizations.

· Monitor patient adherence to medications, treatment plans, and follow-up appointments.

· Document all patient interactions accurately and timely within the electronic medical record (EMR).

· Identify patients at risk for hospitalization or worsening chronic conditions and communicate concerns to providers.

· Assist patients in accessing community resources and support services.

· Review hospital admissions, emergency room visits, and transitions of care.

· Collaborate with clinical staff to improve quality metrics and patient outcomes.

· Ensure compliance with Medicare CCM guidelines and practice policies.

· Participate in team meetings and quality improvement initiatives.

Qualifications Required:

· Licensed Practical Nurse (LPN/LVN)

· Bilingual (English/Spanish)

· Minimum of 1 year of healthcare experience in care coordination, chronic care management, case management, or medical office operations.

· Strong communication, organizational, and customer service skills.

· Experience with electronic medical records (EMR).

· Ability to manage multiple priorities in a fast-paced environment.

· Knowledge of HIPAA regulations and patient confidentiality requirements.

Preferred:

· Cardiology experience preferred.

· Experience with Medicare Chronic Care Management programs.

· Knowledge of cardiovascular disease processes, including heart failure, hypertension, coronary artery disease, atrial fibrillation, and cardiomyopathy.

Skills and Competencies

· Excellent verbal and written communication

· Strong patient engagement and relationship-building skills

· Attention to detail and accurate documentation

· Time management and multitasking abilities

· Problem-solving and critical thinking

· Ability to work independently and collaboratively

Benefits

· Competitive salary

· Medical, dental, and vision insurance

· Paid time off

· Paid holidays

· Retirement plan options

· Supportive team environment

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person