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License Practical Nurse

Barksdale Afb, LA
The Referral Management Center (RMC) serves as the central clearinghouse for providers and patients needing information or help with referrals. Referral Management is a critical program supporting the patient-centered mission.
  • Review initial specialty care and deferred to network primary care referrals for administrative completeness
  • Coordinate with specialty referral clinics.
  • Submit referrals to the appropriate reviewer when required for medical necessity and appropriateness review.
  • Track initial specialty care and deferred to Network primary care referrals to include obtaining reports from MTF, ODCS, network, and non-network providers.
  • Provides patient education regarding specialty care referral, procedures, labs, etc. to prepare the patient for their specialty care appointment/procedure.
  • Facilitates professional and patient care activities.
  • Conducts first level reviews for all referrals to specialty care.
  • Identifies cases that may benefit from alternative levels of care and involves the case manager as needed to provide direction in care management/coordination.
  • Provides nursing consultation and patient education on specialty care and patient's diagnosis.
Licensed Vocational Nurse (LVN/LPN) - RMC Job Qualifications:
  • Graduate from a NLNAC or CCNE accredited program.
  • LVN License: any U.S. state honored. active, unrestricted.
  • Two (2) years of healthcare administrative experience in either an inpatient or outpatient care setting within the last three (3) years, highly preferred.
  • TRICARE - working knowledge.
  • Knowledge and skills to interpret and apply medical care criteria, such as InterQual or Milliman Ambulatory Care Guidelines.
  • Working knowledge of APGs, DRGs, ICD-9, and CPT-4 coding.
  • Excellent oral and written communication skills and interpersonal skills
  • Working knowledge of computers (Internet, Microsoft Word, Microsoft Access, Microsoft Excel, and Windows).
  • HIPAA knowledge a must.
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