LPN Reviewer

1 week ago


Bethesda, Maryland, United States Ivyhill Technologies LLC Full time
Job Title: LPN Reviewer

Job Summary:

Ivyhill Technologies LLC is seeking a skilled LPN Reviewer to join our team. As an LPN Reviewer, you will be responsible for reviewing referrals for appropriateness, administrative and clinical completeness, and Specialty Referral Guideline (SRG) compliance. You will work closely with our team to ensure that patients receive the best possible care.

Key Responsibilities:

  1. Review referrals for appropriateness, administrative and clinical completeness, and SRG compliance.
  2. Collaborate with our team to ensure that patients receive the best possible care.
  3. Work with our healthcare team to resolve any process issues or concerns.
  4. Ensure that consult processing is done within the established Access to Care guidelines.
  5. Process referrals per the guidelines established from the order date or date consult was directed to queues managed by customer.
  6. Enter/process/tracks/closes the ROFR referrals per the guidelines established.
  7. Work with Referral Team to meet the Government's requirement of a minimum of two thousand (2000) CLRS to be posted per month.
  8. Review and disposition referral within 24 hrs. from the date referral was written.
  9. Complete 1200-1600 Referrals with less than 5 mistakes/month.
  10. Review 33,000 to 50,000 referrals per month.

Requirements:

To be successful in this role, you will need:

  1. A minimum of an associate degree and 2 years of experience in a MHS referral management center or clinic Medical Claims or as stated in number 1 below.
  2. A current, active, full, and unrestricted License to practice nursing in accordance with State, and 2 years of clinical nursing experience is required.
  3. Knowledge, skills, and computer literacy to interpret and apply medical care criteria, such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs) or other evidence-base guidelines identified by the MHS.
  4. Excellent oral and written communication skills, interpersonal skills, superior customer service and organizational skills.
  5. Working knowledge of computers, specifically the Internet, Microsoft Word, Excel, PowerPoint, Access, and Windows.

Benefits:

Ivyhill Technologies LLC offers a competitive benefits program, including medical, dental and vision; Life and AD&D insurance; Short- and Long-Term Disability; supplemental Life insurance and a 401(k) Plan.

Ivyhill Technologies LLC is an equal opportunity employer. In compliance with Federal and State Equal Opportunity Laws, qualified applicants are considered for all positions applied for without regard to race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status or any other legally protected status.


  • LPN Reviewer

    2 weeks ago


    Bethesda, Maryland, United States Ivyhill Technologies LLC Full time

    Job Title: LPN ReviewerIvyhill Technologies LLC is seeking a skilled LPN Reviewer to join our team. As an LPN Reviewer, you will play a critical role in ensuring the quality and accuracy of medical referrals.Key Responsibilities:Review medical referrals for appropriateness, completeness, and compliance with guidelines.Collaborate with healthcare teams to...


  • Bethesda, Maryland, United States Zimmerman Associates Full time

    Job Title: Licensed Practical Nurse Referral ReviewerZimmerman Associates, Inc. (ZAI) is seeking a Licensed Practical Nurse Referral Reviewer to support a government contract bid in the Bethesda, MD area. This is an onsite employment opportunity, with consideration for teleworking after 120 days onsite.Role and Responsibilities:Review referrals for...


  • Bethesda, Maryland, United States The Arora Group Full time

    About the RoleWe are seeking a highly skilled Licensed Practical Nurse (LPN) to join our team as a Utilization Reviewer. In this role, you will play a critical part in ensuring the delivery of high-quality patient care while maintaining compliance with government regulations.Key ResponsibilitiesInitiate, perform, and complete assigned duties in providing...


  • Bethesda, Maryland, United States Sunrise Senior Living Full time

    Job Title: LPN Medication TechnicianSunrise Senior Living is a leading provider of senior living communities, and we are seeking a highly skilled LPN Medication Technician to join our team.Job Summary:The LPN Medication Technician is responsible for providing high-quality care and services to our residents by administering medication and treatments in a safe...


  • Bethesda, Maryland, United States Sunrise Senior Living Full time

    Job Title: LPN Medication TechnicianAt Sunrise Senior Living, we are committed to providing high-quality care and services to our residents. We are seeking a skilled LPN Medication Technician to join our team.Responsibilities:Administer medications and treatments in a safe and organized manner.Review and document medication administration records.Collaborate...


  • Bethesda, Maryland, United States Ivyhill Technologies Full time

    Job SummaryIvyhill Technologies is seeking a skilled LPN Reviewer to join our team. As an LPN Reviewer, you will play a critical role in ensuring the smooth operation of our referral management process.Key ResponsibilitiesReview referrals for administrative and clinical completeness, as well as Specialty Referral Guideline (SRG) compliance.Complete the...


  • Bethesda, Maryland, United States Ivyhill Technologies Full time

    Job SummaryIvyhill Technologies is seeking a skilled LPN Reviewer to join our team. As a key member of our referral management center, you will play a critical role in ensuring the smooth processing of referrals for our patients.Key ResponsibilitiesReview referrals for administrative and clinical completeness, as well as Specialty Referral Guideline (SRG)...


  • Bethesda, Maryland, United States Zimmerman Associates Full time

    Job Title: Licensed Practical Nurse Referral ReviewerZimmerman Associates, Inc. (ZAI) is seeking a skilled Licensed Practical Nurse Referral Reviewer to support a government contract bid in the Bethesda, MD area. This is an onsite employment opportunity, with consideration for teleworking after 120 days onsite.Role and Responsibilities:Review referrals for...


  • Bethesda, Maryland, United States Zimmerman Associates, Inc Full time

    Job Title: Licensed Practical Nurse Referral ReviewerZimmerman Associates, Inc. is seeking a highly skilled Licensed Practical Nurse Referral Reviewer to support a government contract bid in the Bethesda, MD area.Job Summary:The Licensed Practical Nurse Referral Reviewer will be responsible for reviewing referrals for appropriateness, administrative and...


  • Bethesda, Maryland, United States Zimmerman Associates Full time

    Job Title: Licensed Practical Nurse Referral SpecialistZimmerman Associates, Inc. (ZAI) is seeking a Licensed Practical Nurse Referral Specialist to support a government contract bid in the Bethesda, MD area. This is an onsite employment opportunity, with consideration for teleworking after 120 days onsite.Role and Responsibilities:Review referrals for...


  • Bethesda, Maryland, United States Vistant Corp Full time

    Job Title: Licensed Practical NurseVistant Corp, a leading public-sector management consulting firm, is seeking a skilled Licensed Practical Nurse (LPN/LVN) to support the mission of the Department of Radiology/Oncology Services at Walter Reed National Military Medical Center (WRNMMC).Job Summary:The contracted LPN/LVN will provide patient care through a...


  • Bethesda, Maryland, United States Zimmerman Associates Full time

    Job Title: Licensed Practical Nurse Referral ReviewerZimmerman Associates, Inc. (ZAI) is seeking a skilled Licensed Practical Nurse Referral Reviewer to support a government contract bid in the Bethesda, MD area. This is an onsite employment opportunity, with consideration for teleworking after 120 days onsite.Role and Responsibilities:Review referrals for...


  • Bethesda, Maryland, United States Vistant Corp Full time

    Job Title: Licensed Practical NurseVistant Corp, a leading public-sector management consulting firm, is seeking a skilled Licensed Practical Nurse (LPN/LVN) to join our team at Walter Reed National Military Medical Center. As a key member of our Radiology/Oncology Services department, you will play a vital role in providing high-quality patient care and...


  • Bethesda, Maryland, United States Zimmerman Associates, Inc Full time

    Job Title: Licensed Practical Nurse Referral ReviewerZimmerman Associates, Inc. is seeking a highly skilled Licensed Practical Nurse Referral Reviewer to support a government contract bid in the Bethesda, MD area. This is an onsite employment opportunity, with consideration for teleworking after 120 days.Job Summary:The Licensed Practical Nurse Referral...


  • Bethesda, Maryland, United States Zimmerman Associates, Inc Full time

    Job Title: Licensed Practical Nurse Referral ReviewerZimmerman Associates, Inc. (ZAI) is seeking a highly skilled Licensed Practical Nurse Referral Reviewer to support a government contract bid in the Bethesda, MD area. This is an onsite employment opportunity, with consideration for teleworking after 120 days onsite.Role and Responsibilities:Review...

  • Care Coordinator

    5 days ago


    Bethesda, Maryland, United States Cynet Systems Full time

    Job Title: Care Coordinator Job Summary: We are seeking a highly skilled Care Coordinator to join our team at Cynet Systems. As a Care Coordinator, you will play a vital role in collaborating with our interdisciplinary team to provide exceptional care to our members. Your primary responsibility will be to coordinate services and treatment plans, ensuring...

  • Care Coordinator

    3 weeks ago


    Bethesda, Maryland, United States Cynet Systems Full time

    Care Coordinator Job DescriptionWe are seeking a highly skilled Care Coordinator to join our team at Cynet Systems. As a Care Coordinator, you will play a vital role in ensuring the seamless coordination of healthcare services for our members.Responsibilities:Collaboration and Communication: Work closely with our interdisciplinary team to provide clear...

  • LPN Reviewers

    2 weeks ago


    Bethesda, United States Ivyhill Technologies Full time

    Ivyhill has an immediate need for LPN Reviewers for its project located in Bethesda, MD. The qualified candidates will perform all tasks associated with referral reviews in a medical appointing call center environment. Duties and Responsibilities Review all details of referral for appropriateness, administrative and clinical completeness, and Specialty...

  • LPN Reviewers

    3 weeks ago


    Bethesda, United States Ivyhill Technologies LLC Full time

    Ivyhill has an immediate need for LPN Reviewers for its project located in Bethesda, MD. The qualified candidates will perform all tasks associated with referral reviews in a medical appointing call center environment. Duties and Responsibilities Review all details of referral for appropriateness, administrative and clinical completeness, and Specialty...


  • Bethesda, United States Zimmerman Associates, Inc Full time

    Zimmerman Associates, Inc. (ZAI) is currently seeking to hire a Licensed Practical Nurse Referral Reviewer to support a government contract bid in the Bethesda, MD area. This is an onsite employment opportunity. However, consideration will be provided for teleworking after the successful completion of 120 days onsite. ROLE AND RESPONSIBILITIES: The...


  • Bethesda, United States Johns Hopkins Medicine Full time

    Apply Refer a Friend Back Share This Page Share on Facebook Share on Twitter Share on LinkedIn Share via Email Job Details Requisition #: 646041 Location: Suburban Hospital, Bethesda, MD 20814 Category: Nursing Schedule: Evening ShiftSuburban Hospital is a 228-bed, not-for-profit, community-based hospital in Bethesda, Maryland. Suburban Hospital is a...


  • Bethesda, United States Vierra Communities Full time

    Job DescriptionPosition: LPN - Full-time - Skilled Nursing Facility Are you looking to put your skills and the compassion you have for people to work with an employer that values you and the work you do? If so, Carriage Hill Bethesda is looking for you. If you are motivated, reliable and have a strong work ethic, we invite you to join our amazing team in...

  • Care Coordinator

    1 week ago


    Bethesda, United States Synectics Full time

    Description Point of contact for individual members and supports the member by taking a holistic, and supportive approach to the member's healthcare.Sensitive to the needs and characteristics of the unique population of Members serviced by the WTC-NPN.Collaborates on an interdisciplinary team including RN Case Managers and Social Worker to meet the needs of...

  • Care Coordinator

    2 weeks ago


    Bethesda, United States Synectics Full time

    Description Point of contact for individual members and supports the member by taking a holistic, and supportive approach to the member's healthcare. Sensitive to the needs and characteristics of the unique population of Members serviced by the WTC-NPN. Collaborates on an interdisciplinary team including RN Case Managers and Social Worker to meet the needs...

  • Sleep Technician

    3 weeks ago


    Bethesda, United States Akahi Associates, LLC Full time

    OverviewJob Title: Sleep Technician Overall Position Summary and Objectives: Under this task order, the contractor will independently provide support services to satisfy the overall operational objectives of the National Institute of Mental Health (NIMH). Weekly Hours/Schedule: 24 hours/week, Monday - Friday on nights Work Location: NIMH - Bethesda,...

  • Care Coordinator

    4 weeks ago


    Bethesda, United States Cynet Systems Full time

    Job Description: Pay Range: $21hr - $26hr Responsibilities: Collaborates as an integral member of the WTC-NPN case management interdisciplinary team through clear communication and resource coordination to meet the shared goal of creating and nurturing a caring environment, supporting a better quality of life for the Member and reducing health care...

  • Care Coordinator

    4 weeks ago


    Bethesda, United States Synectics Inc Full time

    Job DescriptionJob DescriptionDescriptionPoint of contact for individual members and supports the member by taking a holistic, and supportive approach to the member's healthcare. The Care Coordinator is sensitive to the needs and characteristics of the unique population of Members serviced by the WTC-NPN. The Care Coordinator collaborates on an...

  • RN Case Manager

    3 months ago


    Bethesda Home Health, United States Bethesda Health Full time

    Bethesda Brings out the Best in Talented, Caring People!At Bethesda, more than 1,200 employees dedicate their careers to improving the lives of others. As a team member at Bethesda, you'll enjoy great benefits such as: 403b, daily pay, bonuses, career advancement opportunities, and holiday pay. Medical, dental, vision, prescription, and life insurance...

  • RN Case Manager

    3 months ago


    Bethesda Home Health, United States Bethesda Health Full time

    Bethesda Brings out the Best in Talented, Caring People!At Bethesda, more than 1,200 employees dedicate their careers to improving the lives of others. As a team member at Bethesda, you'll enjoy great benefits such as: 403b, daily pay, bonuses, career advancement opportunities, and holiday pay. Medical, dental, vision, prescription, and life insurance...