What are the responsibilities and job description for the Referred Care Coordinator LPN position at the Chickasaw Nation?
We are currently looking for a Full Time Referred Care Coordinator LPN to join our RN Patient Care Team team located at the Chickasaw Nation Medical Center.
Summary:
Ensures patient access to contract care by managing, planning, integrating coordinating, and controlling the functions of case management.
Responsibilities:
- Assists patients in scheduling appointments
- Collaborates with the RN to perform complex and extensive chart audits and summarizes treatment history in preparation for Medisaw committee review
- Coordinates private insurance authorizations, coordinates private insurance appeals, and communicates care management needs to referring providers
- Facilitates communication between the patient and the Medical Staff of results, follow up directions, and medical advice, etc.
- Assists patients and providers with navigational needs through Purchased Referred Care (PRC) service unit processes
- Assesses incoming referrals and identifies care management needs
- Facilitates specialty care needs as requested by external Purchased Referred Care (PRC) programs, under guidance from RN
- Works closely with the Medisaw program to ensure coordination of contract health services
- Works to ensure patient access to contract care and maintain customer satisfaction
- Serves as a liaison for the providers requesting contract health services for their patients
- Serves as the patient advocate in representing the patients’ best interest during the coordination of care process
- Ensures that case management activities are ethical and of value to the patient, their family and provider of care both within and outside the health system
- Provides first class customer service to both internal and external customers and responds to inquiries, compliments, and/or complaints with professionalism, courtesy, and efficiency
- Completes all training and development requirements and participates in continuing education opportunities
- Works in a collaborative and supportive manner to support the productivity and safety of the work area, team members and customers of all types
- Maintains a clean, organized work area and ensures a safe environment
- Maintains and promotes professionalism
- Punctual and consistent in meeting start time, work schedule, attendance and other assigned work time metrics
- Adheres to Chickasaw Nation dress code standards
- Maintains knowledge of and follows all rules, regulations, policies and guidelines for assigned area
- Performs all other duties as assigned
Competencies:
Essential:
Essential:
- Ability to make sound judgements
- Demonstrated ability and skill in auditing and interpreting medical records
- Able to follow instructions, both written and oral
- Able to adhere to all scheduling and attendance requirements
- Ability to maintain a high level of confidentiality in all matters
- Honesty, truthfulness, reliability, accountability
- Able to read, understand, apply, and retain knowledge of Chickasaw Nation, departmental, divisional and all other rules, regulations, policies, procedures and guidelines
- Demonstrated ability to solve highly complex technical, organizational, and operational problems
- Knowledge of reimbursement systems
- Knowledge and understanding of special populations, including sensitivity to the First American culture
- Knowledge of the contract health/purchased referred care
- Strong leadership, communication, and interpersonal skills, with the ability to lead and motivate team members
- Establishes professional working relationships as appropriate
- Able to verbally communicate in a professional and positive manner with other team members, departments, guests and management
Skills:
Essential:
Essential:
- Must be familiar with the Microsoft Office Suite of products
Experience:
Nonessential:
Nonessential:
- 3 years directly related experience
Education:
Essential:
Essential:
- High School, GED or Equivalent
- Graduate of an accredited school of practical nursing
Credentials:
Essential:
Essential:
- Licensed Practical Nurse
- Pass general background check
Working Conditions:
Essential:
Essential:
- Works in an office setting
- May be required to assist individuals who are hostile, agitated or under the influence
- May be required to assist individuals with unmanaged emotions
- Sometimes lift and or carry up to 50 lbs
- Sitting up to 75% of shift
- Walking up to 100% of shift
- Pass pre-employment drug test
Training
- It is the responsibility of each employee to attend required training for their position or profession as determined by their line of support (LOS) or the leadership of the Chickasaw Nation. It is the responsibility of those who supervise, manage or otherwise lead employees or teams to ensure each employee has access to and receives all required training.
Mission, Vision & Core Values
Mission:
Mission:
- To enhance the overall quality of life of the Chickasaw people.
- To be a nation of successful and united people with a strong cultural identity.
- The Chickasaw People
- Cultural Identity
- Servant Leadership
- Selflessness
- Can Do Attitude
- Perseverance
- Stewardship
- Trust and Respect
- Loyalty
- Honesty and Integrity
- Teamwork