License Practical Nurse

Reef Systems
Goodfellow AFB, TX Full Time
POSTED ON 4/17/2024
TLicensed 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:
    • 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.
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.
Physical Requirements:
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      

Salary.com Estimation for License Practical Nurse in Goodfellow AFB, TX
$46,151 to $56,272
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