Job Description
Job Description
GiaCare Inc., in anticipation of a future government contract award, is now accepting applications for experienced, civilian Licensed Practical Nurses (LPN / LVN) to work alongside the federal government, in support of the Air Force Academy.
Requirements
- Degree / Education : Certificate. Graduation from a State Board of Nursing approved LPN / LVN training program or completion of equivalent military training that permits sitting for the State licensure examination.
- Life Support Certifications : Basic Life Support (BLS) certification
- Experience :
Three (3) years of clinical experience.
Working knowledge of computers, specifically the Internet, Microsoft Word, Microsoft Access, Microsoft Excel and WindowsRead, understand, speak, and write English well enough to communicate effectively.Knowledgeable in general medical ethics, health records administration, excellent communications and customer service skills.Shall provide consultation and administrative support.Board Certification : N / A.Licensure / Registration : Current, full, active, and unrestricted license as a practical or vocational nurse.Duties
Performs data collection and review to identify areas requiring intensive management. Analyzes data collected and prepares reports describing resource utilization patterns. Disseminates information to government members of collaborative teams and multidisciplinary hospital committees.Coordinates specialty care referrals. They shall review specialty care referrals for appropriateness, completeness and disposition the referral to the appropriate place of care.Serves as functional expert in the area of health benefits and provides health benefits advice to patients.Maintains and tracks referral records.Participates with referral centers in providing, assessing, and improving a wide variety of customer services / relations.Assists in the management of all forms of communication between beneficiaries, referral centers, internal staff and providers, network / outside providers and ancillary healthcare workers.Working knowledge of latest versions of office automation software utilized in their area of expertise required; working knowledge of EHR Genesis and Managed Care Support Contractor (MCSC) databases is required.Knows and understands the principles of utilization review (UR) and utilization management (UM) and applies knowledge in processing specialty referrals.Plans and performs specialty referral reviews IAW established guidelines to provide quality cost-effective care.Conducts first level reviews for all referrals to specialty care.Acts a facilitator of professional and patient care activities.Interfaces with the MCSC and multidisciplinary personnel as needed to ensure appropriateness of referrals.Identifies cases that may benefit from alternative levels of care and involves the case manager as needed to provide direction in care management.Plans and prioritizes UR activities to ensure identified patient needs are addressed promptly.Effectively utilizes information systems to develop, design, analyze, update and record data.Facilitates the development and integration of UM review policies and procedures into operations.Performs Right of First Refusal coordination of specialty care referrals. Shall review specialty care referrals for appropriateness, completeness and disposition the referral to the appropriate place of care.ROFR knowledge in the area of health benefits and provides health benefits advice to patients.Maintains and tracks referral records.As a GiaCare Inc. employee, you may enjoy the following benefits :
Medical Insurance (GiaCare pays for employee's medical benefits)Vision InsuranceDental InsuranceShort-Term Disability InsuranceLife and AD&D InsurancePaid Time Off (PTO)401k (Non-matching)Employee Referral ProgramMUST BE US CITIZEN