Licensed Practical Nurse Care Coordinator Full Time Days at AdventHealth

Date Posted: 7/23/2019

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Tampa, FL
  • Job Category
  • Date Posted:
    7/23/2019
  • Job ID:
    19011516
  • Job Family
    Administrative
  • Travel
    No
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Carrollwood

Job Description


Description

"Licensed Practical Nurse Care Coordinator Full Time Days" AdventHealth Carrollwood

Location Address: 7171 North Dale Mabry Highway Tampa, Florida 33614

Top Reasons to Work At AdventHealth Carrollwood
  • Family-like culture
  • Teamwork driven both inter Dept and multidisciplinary
  • Positive working climate to support a well-balanced work life balance
 
Work Hours/Shift:
Full Time Days
 
You Will Be Responsible For:
SERVICE:

•           Communicates with courtesy and respect

•     Patient satisfaction scores meet organization goals

•     Maintains professional appearance

•     Provides hospital information to members of CM/CDIS

•     Committed to working as a team to improve Employee satisfaction and engagement scores.

•     Data entry meets department standard on a daily basis

PEOPLE:

•     Demonstrates care and respect for each person’s unique contributions, provides utilization review care that is non-judgmental and non-discriminatory

•     Demonstrates respect for human dignity and self-worth

•     Respects patient privacy, confidentiality, and dignity by adherence to all HIPAA regulations

•     Maintains a professional appearance and manner.

•     Daily interaction with department staff is that of a team player

FINANCE:

•     Enters initial and concurrent reviews on routine cases into Cerner Care Manager on managed care cases and sends by electronic fax to managed care company CM

•     After consultation with Unit CM, communicates physician’s plan of care by electronic fax or manual fax to managed care companies according to applicable HIPAA regulations

•     Communicates relevant information to CM’s, Manager of CM, Directors from Managed Care companies regarding authorizations, potential denials, etc.

•     Follows up to ensure all days are authorized by managed care company, consults with Unit CM if additional clinical information is needed.

OUTCOMES:

•     Runs reports of managed care cases to ensure authorization numbers are entered and all days approved

•     If days are carved out or denied, enters denials into the denial screen in Cerner, assigns them to the appeal manager.

•     Completes all daily reports as directed by the Director and/or Manager CM

•     Other duties as required
GROWTH:

•     Demonstrate commitment to professional and personal growth

•     Attends conferences and seminars related to revenue cycle, managed care as available


Qualifications
What You Will Need:
  • Current license as a Licensed Practical Nurse (LPN)  in Florida or licensure from another state with verification of application and eligibility for Florida licensure by endorsement.
  • Graduate of an accredited School of Nursing, LPN Nursing
  • One year of experience in Case Management or in the Managed Care arena
  • Individuals must possess these knowledge, skills and abilities and be able to explain and to demonstrate that s/he can perform the essential functions of the job, with or without reasonable accommodation, using some other combination of skills and abilities.
    • Knowledge of medical terminology
    • Computer competence, Excel, Access, Word and Power Point
    • Data entry competencies
    • Proven clerical skills, typing and filing
    • Excellent oral communication skills
    • Excellent time management skills

PREFERRED:

•        Any combination of education, training or experience that provides the knowledge, skills and abilities required to successfully accomplish the assigned duties and responsibilities of the position.

•        Knowledge of concepts and processes regarding managed care authorizations, denials and appeals.

  • LPN, and  Associate’s degree and/or working knowledge of hospital revenue cycle and coding, medical billing.
•      Knowledge of Managed Care
•      CPUR, CPHM
 
Job Summary:

Responsible for performing duties which support the activities and organization of the Case Management function.  Responsible for obtaining all authorization numbers for inpatient stays of 1 to 3 days.  Supports the Case Managers with reports for required clinical information.  Decreases the number of inpatient denials by timely authorization of inpatient admissions.  Supports the Case Management staff with other clerical and data entry activities.



This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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