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License Practical Nurse
Goodfellow AFB, TXTLicensed Practical Nurse
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.
Job Responsibilities:
The work is primarily sedentary; however, the physical demands include prolong walking, standing and sitting or bending.
Work Location:
San Angelo, TX 76908
Schedule:
The work schedule is Monday – Friday, 7:30 AM to 4:30 PM with an hour lunch.
Point of Contact for this Opportunity:
Great benefits and compensation. Let’s Talk!
Tiffany Vines tvines@reef-sys.com
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.
Job Responsibilities:
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- 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.
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- 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.
The work is primarily sedentary; however, the physical demands include prolong walking, standing and sitting or bending.
Work Location:
San Angelo, TX 76908
Schedule:
The work schedule is Monday – Friday, 7:30 AM to 4:30 PM with an hour lunch.
Point of Contact for this Opportunity:
Great benefits and compensation. Let’s Talk!
Tiffany Vines tvines@reef-sys.com