Position Summary
The Annual Wellness Nurse (LPN) is responsible for coordinating and completing Medicare Annual Wellness Visits (AWVs) under the supervision of a physician, nurse practitioner, or physician assistant. This position focuses on preventive care, health screenings, patient education, chronic disease management support, and closing preventive care gaps to improve patient outcomes and quality metrics.
The Annual Wellness Nurse works collaboratively with providers, care coordinators, and support staff to ensure patients receive comprehensive preventive services while maintaining compliance with CMS guidelines and practice protocols.
Essential Duties and ResponsibilitiesAnnual Wellness Visits
- Schedule and coordinate Medicare Annual Wellness Visits.
- Conduct Health Risk Assessments (HRA).
- Obtain and document:
- Vital signs
- Height, weight, BMI
- Blood pressure
- Tobacco and alcohol history
- Social determinants of health
- Review and update:
- Medical history
- Surgical history
- Family history
- Medication list
- Allergies
- Complete medication reconciliation.
- Perform depression screening (PHQ-2/PHQ-9).
- Complete fall risk assessments.
- Perform cognitive screening using approved tools.
- Assess activities of daily living and functional status.
- Review immunization status.
- Identify preventive screening gaps.
Preventive Care Coordination
- Educate patients regarding preventive services.
- Coordinate referrals for:
- Mammograms
- Colon cancer screening
- Bone density testing
- Lung cancer screening
- Vaccinations
- Diabetic eye exams
- Other preventive services
- Ensure recommended screenings are documented and scheduled.
Quality & Population Health
- Support CMS quality initiatives.
- Assist with HEDIS, MIPS, ACO, and value-based care measures.
- Identify and close preventive care gaps.
- Participate in outreach to patients due for Annual Wellness Visits.
- Maintain quality documentation within the EHR.
Patient Education
- Educate patients regarding:
- Healthy lifestyle habits
- Nutrition
- Exercise
- Smoking cessation
- Fall prevention
- Chronic disease self-management
- Reinforce provider recommendations and individualized prevention plans.
Documentation
- Document all assessments accurately in eClinicalWorks (eCW).
- Ensure documentation meets CMS Annual Wellness Visit requirements.
- Prepare the provider for completion of the Personalized Prevention Plan.
Collaboration
- Work closely with physicians, NPs, PAs, care coordinators, referral coordinators, and front office staff.
- Communicate abnormal findings promptly to the provider.
- Assist with additional nursing duties as assigned.
QualificationsEducation
- Graduate of an accredited Practical Nursing program.
Licensure
- Current Georgia Licensed Practical Nurse (LPN) license.
- Current BLS certification.
Experience
Preferred:
- Two years of primary care or internal medicine experience.
- Two years experience with Medicare Annual Wellness Visits.
- Two years experience with eClinicalWorks (eCW).
- Experience with population health or quality programs.
Knowledge and Skills
- Knowledge of Medicare preventive services.
- Strong understanding of chronic disease management.
- Excellent patient education skills.
- Strong organizational and time-management skills.
- Excellent verbal and written communication.
- Ability to work independently while maintaining provider collaboration.
- Proficient computer and EHR skills.
Physical Requirements
- Ability to stand and walk for extended periods.
- Ability to lift up to 25 pounds.
- Frequent sitting, bending, reaching, and keyboard use.
Performance Expectations
The Annual Wellness Nurse is expected to:
- Complete 8–12 Medicare Annual Wellness Visits per day (practice volume dependent).
- Maintain accurate and timely documentation.
- Achieve high patient satisfaction scores.
- Support closure of preventive care gaps.
- Meet departmental quality and productivity goals.
- Maintain compliance with CMS documentation requirements.
Pay: $25.00 - $28.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
