Clinical Admissions Liaison LPN

MedWatch•Lake Mary, FL

7d•Hybrid

About The Position

The Clinical Admissions Liaison will assist the Case Management Department with clinical and clerical intake functions, verify clinical and clerical information pertaining to active and potential Case Management cases, monitor and process Case Management referrals and approval for services in concert with the Executive Director of Case Management and assist the Case Managers with the processing of cases. The incumbent may be responsible for duties or responsibilities that are not listed in this job description. Duties and responsibilities may change at any time with or without notice.

Requirements

Licensed Practical Nursing Education.
Licensed Practical Nurse (current active and unrestricted, in current state of practice and residence, within the United States or its territories)
Good organizational skills and time management
Excellent verbal and written communication skills
Ability to handle difficult situations tactfully and diplomatically.
Effective problem solving and decision-making skills.
Strong computer skills with proficiency in MS Office Suite products (Word, Excel, PowerPoint)

Nice To Haves

5 years of varied clinical experience preferred, or three years in a specialty field.
Leadership skills a plus

Responsibilities

Practice within the scope of his/her licensure.
Operate under the direct supervision of the Director of Case Management and will perform functions as directed by the Director of Case Management, within the scope of his/her licensure.
Determine Case Management case opening requirements based on the service contract.
Collaborate with all Departments within MedWatch (Client Success, Intake, Concierge, etc.) to determine appropriateness of case opening and case direction and to obtain necessary information for case processing.
Answer incoming calls needing clinical and clerical information.
Differentiate and prioritize incoming calls by company, admission type and/or review type to facilitate timely processing.
Answer customer’s questions and concerns or direct to the appropriate person, office or claims customer service team.
Make outgoing calls to customers, providers, patients, to obtain necessary information.
Obtain clinical and demographic data or other related information from customers, providers, employees/patients, and employer groups.
Enter clinical and demographic date or other related information into computer data system
Maintain accurate, current knowledge with regards to URAC and State precertification requirements and company specific contract requirements.
Maintain and enter accurate program data.
Maintain effective, diplomatic working relationships with customers, providers, employees/patients, employer group, and MedWatch internal staff.
Relate well to all types of health care professionals and customers.
Participate in the Quality Management Program by adhering to all company policies and procedures and identifying opportunities for improvement to ensure quality services are rendered to clients and customers.
Assist with processing reconsiderations and appeals reviews.
Assist with assigning cases to Case Managers.
Assist with oversight of the admissions process and admissions staff.