LPN Care Coordinator, Embedded; Prince Georges County, MD

About Us

Ennoble Care is a mobile primary care, palliative care, and hospice service provider serving patients in New York, New Jersey, Maryland, DC, Virginia, Oklahoma, Kansas, Pennsylvania, and Georgia. Our clinicians visit patients at home, providing a continuum of care for those with chronic conditions and limited mobility. We offer programs such as remote patient monitoring, behavioral health management, and chronic care management to ensure the highest quality of care by a team patients know and trust.

We seek driven individuals who embody our motto, “To Care is an Honor.” Join Ennoble Care today!

As an Embedded Care Coordinator, you will work on‑site in one or more partnered long‑term care facilities in Prince George’s County, Maryland. This integral role involves monitoring residents’ conditions, preventing unnecessary hospitalizations, and supporting patients to stay healthy in their homes.

At Ennoble Care our mission is simple:
To care is an honor. As an LPN Embedded Care Coordinator you will deliver transitional care management, attentive patient monitoring, and daily collaboration with our clinical team and facility staff—serving as a reliable communication bridge among residents, families, facility staff, and our House calls division.

• Legally authorized to work in the United States
• Active, unrestricted LPN license in Maryland
• Minimum 1 year of patient‑facing experience in long‑term care, skilled nursing, or transitional care
• Comfortable communicating throughout the day in person, by phone, email, and Microsoft Teams
• Strong clinical assessment skills and ability to identify and escalations
• Experience with EMR systems (Point Click Care preferred)
• Proficient with Microsoft 365 (Excel, Outlook, Word, Teams)
• Excellent communication, organization, time‑management, and documentation skills
• Capacity to work independently while collaborating with multidisciplinary teams
• Ability to work full‑time in an on‑site role in Prince George’s County, MD
• Passes background check and drug screen
• Valid, unencumbered driver’s license, reliable personally‑owned vehicle, current auto insurance (proof required)

Schedule:

Thursday through Monday, 8:00 a.m. – 4:30 p.m. EST (no evenings, no overnight shifts, no on‑call, 7 company‑paid holidays).

Travel between facilities may be required.

• Coordinate care for residents in skilled nursing and rehabilitation facilities using Ennoble Care’s EMR
• Facilitate transitional care management and ensure House calls services are initiated immediately after hospital discharge
• Expedite time to first provider visit for newly transitioned patients per established guidelines
• Monitor patients attentively; promptly communicate changes, initiate interventions, and escalation as clinically indicated (including CCM‑billable activities)
• Support care coordination efforts to reduce avoidable ED visits and readmissions
• Collaborate daily with providers and facility staff to keep care plans current and acted on
• Maintain consistent on‑site presence; build relationships with residents and families
• Conduct routine and urgent vital‑sign collection and patient check‑ins to support care plans and clinical stability
• Identify and communicate any changes in patient condition to the clinical team
• Serve as a liaison among Ennoble Care providers, facility staff, residents, families, and the House calls team
• Provide timely, accurate clinical updates to support informed decision‑making
• Convert at least two eligible patients per day to Ennoble Care’s House calls program
• Accurately document patient interactions, assessments, and care coordination activities in the EMR
• Perform chart reconciliation to ensure accuracy and continuity between Ennoble and facility records
• Follow established workflows, documentation standards, and escalation protocols
• Support onboarding, training, and mentorship of new Embedded Care Coordinators
• Promote best practices in transitional care, communication, and facility‑based coordination
• Contribute to team collaboration and foster strong partnerships with facility staff

• P…