Job Title
LPN/LVN – Case Manager (Transitions of Care)
Location
Rochester, NY | Mobile / Community-Based Care Management
Schedule / Job Type
Contract | Full-Time | Days, Monday–Friday, 8:00 a.m.–4:30 p.m. | Mobile / Remote with On-Site Travel Requirements
Key Responsibilities
Support the Transitions of Care program with a focus on reducing 30-day readmission rates, working under the direction of an RN Care Manager to assist with implementing individualized care plans.
Manage a rotating monthly caseload of approximately 25–40 patients, maintaining frequent patient contact through telephonic outreach, home visits, hospital visits, and provider office visits.
Coordinate appointment scheduling, biometric data monitoring, patient education, and community resource linkage.
Participate in virtual multidisciplinary care team rounds alongside RNs, Social Workers, Pharmacists, and other professionals to provide patient updates.
Document all patient interactions and care activities accurately in the Electronic Health Record (EHR).
Triage patient barriers to care, reinforce medication adherence education, and support goal reassessment to transition patients to appropriate long-term management programs.
Required Qualifications
Active New York State LPN license required and must be in hand at time of submission.
Basic Life Support (BLS) certification required.
EPIC EHR experience is a hard requirement.
Minimum 1 year of experience in a home health or mobile case management setting.
Access to reliable personal transportation required for travel during the workday (LPNs will not transport patients).
Must reside at least 75 miles from the facility to be eligible for this position.
Preferred Experience / Skills
Clinical knowledge or experience working with patients diagnosed with CHF, COPD, or multiple complex comorbidities.
Familiarity with community resources and care coordination principles.
Strong independent work ethic with the ability to remain flexible and adapt throughout the workday.
Clear and concise verbal and written communication skills, particularly for documentation and multidisciplinary team collaboration.
Why Join Us
Opportunity to work within a collaborative, multidisciplinary care team in a meaningful program designed to improve patient outcomes and reduce hospital readmissions.
Dynamic, mobile role offering variety in daily work across community, home, and clinical settings with an expected schedule of 40 hours per week, Monday through Friday.
Benefits
• Day 1 health benefits (medical/dental/vision)
• Weekly pay
• Direct deposit
• $1,500 referral bonus program
About Us
All Medical Personnel is a leading national temporary employment agency for healthcare workforce solutions in the United States. Established in 1990, our staffing business lines place locum tenens, travel nursing, allied health, and clinical laboratory professionals on temporary and temp to hire assignments from coast to coast. Explore our current opportunities and sign up for job alerts:
All Medical Personnel is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all qualified individuals without regard to race, color, religion, sex, national origin, age, disability, genetic information, veteran status, or any other characteristic protected by applicable law.
Florida Background Screening Requirement:
Certain Florida assignments require a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse before placement. Learn more about the screening process and requirements at:
