Licensed Vocational Nurse

6 days ago

Tampa, Florida, United States Epic Government Full time
Job Title: Licensed Vocational Nurse - Referral Management Specialist

Epic Government is seeking a highly skilled Licensed Vocational Nurse (LVN) to join our team as a Referral Management Specialist. In this role, you will play a critical part in the Referral Management Center, working closely with healthcare providers and patients to ensure seamless referrals and care coordination.

Job Summary:

The Referral Management Specialist will be responsible for reviewing initial specialty care referrals, coordinating with specialty referral clinics, and submitting referrals to the appropriate reviewer for medical necessity and appropriateness review. You will also track initial specialty care and deferred to Network primary care referrals, obtaining reports from MTF, ODCS, network, and non-network providers.

Key Responsibilities:
  • Review initial specialty care referrals for administrative completeness
  • Coordinate with specialty referral clinics
  • Submit referrals to the appropriate reviewer for medical necessity and appropriateness review
  • Track initial specialty care and deferred to Network primary care referrals
  • Obtain reports from MTF, ODCS, network, and non-network providers
  • Provide patient education regarding specialty care referrals, procedures, labs, etc.
  • Facilitate professional and patient care activities
  • Conduct first-level reviews for all referrals to specialty care
Requirements:
  • 2 years of healthcare administrative experience in either an inpatient or outpatient care setting within the last 3 years
  • Graduate from a NLNAC or CCNE accredited program
  • Active, unrestricted LVN license in any U.S. state
  • Working knowledge of TRICARE and facility security
  • Ability 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
About Epic Government:

Epic Government employs healthcare professionals at government medical facilities providing care to military service members, retirees, and their families. We are committed to building mutually beneficial, sustainable partnerships with healthcare professionals and our clients nationwide.

We are an award-winning organization built with committed professionals with a unified vision of helping others. We are honored to be named one of the Baltimore Sun's Top Workplaces.

Epic Government is an Equal Opportunity Employer, committed to diversity and inclusion. We 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.

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