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    Referral Management LPN/ LVN - Sumter, SC, United States - Epic Government

    Epic Government
    Epic Government Sumter, SC, United States

    1 week ago

    Default job background
    Full time
    Description
    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

    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 a), a) and 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.

    #OFCCP


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