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ambulatory care coordinator - San Antonio, TX , USA, United States - University Health System
Description
Full Time4400 NW Loop 410, Suite 300
Nursing
Day Shift
POSITION SUMMARY/RESPONSIBILITIES
Reviews referrals from providers throughout the system and applies established guidelines as necessary. Acts as liaison between patients, physicians, and other staff members. Coordinates referrals to hospitals and specialists in accordance with HMO/PPO/payor procedures and guidelines. Communicates with medical director and/or physicians about referrals and performs outsourcing function as needed
EDUCATION/EXPERIENCE
Current LVN license is required. Three years of nursing experience in multiple specialty areas with some in Managed Care/ HMO/ IPA setting preferred. Completion of some college business courses is preferred. Member Service / Call Center experience preferred. Knowledge of Quality Management (QM) principles and Utilization Management tools preferred. Microsoft Office (Excel, Access, Word) experience a plus.