Licensed Vocational Nurse (LVN/LPN) - Referral Management Center job in Charleston, South Carolina.
Veterans and Military Spouses Encouraged to Apply
Civilian position on Shaw Air Force Base
Monday-Friday days
Benefits:
Health and Welfare Fringe Benefits
Paid Time Off
Paid Holidays
Paid Sick Time
Company-funded match and safe harbor 401(k)
Medical, Dental and vision plans available
Life insurance and accidental death plans available
Short-term and long-term disability plans available
TRICARE Supplemental available
Supplemental Benefit plans available
Referral bonuses
Employee Assistance Program
Pet Insurance Plans available
Will Preparation Services available
Licensed Vocational Nurse (LVN/LPN) - Referral Management Center Job Overview:
The is a civilian position at Shaw Air Force Base. Civilian and military healthcare providers work together to provide a full range of services to the military community.
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:
2 years of healthcare administrative experience in either an inpatient or outpatient care setting within the last 3 years, highly preferred
Graduate from a NLNAC or CCNE accredited program
LVN License: any U.S. state honored. active, unrestricted.
TRICARE - working knowledge
Ability to obtain facility security
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
FSRpeople.com
FSR provides healthcare professionals to government facilities supporting active duty military service members, retirees, and their families. FSR began as a women-owned, minority-owned, small business in Maryland and has grown to an award-winning organization serving the federal government nationwide and around the globe.
We invite you to join our team!
Federal Staffing Resources dba FSR is an Equal Opportunity Employer: disability/veteran/military spouse
This contractor and subcontractor shall abide by the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). These regulations prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity or national origin. Moreover, these regulations require that covered prime contractors and subcontractors take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.
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