FSR (Federal Staffing Resources)
  • San Angelo, TX, USA
  • Full Time

Licensed Vocational Nurse (LVN / LPN) - RMC job in San Angelo, Texas. 

  • Monday-Friday
  • Days Only
  • Full-time hours
  • Holidays off (and paid)
  • PTO
  • Benefits (health, dental, and vision)

Licensed Vocational Nurse (LVN / LPN) - RMC Job Overview:

The job is based on Goodfellow Air Force Base and is a civilian position. Civilian and military healthcare providers work together to provide a full range of services to the military community. 

The Referral Management Center (RMC) serves athe central clearinghousfor providers and patients needing information or help with referrals. Referral Management is a critical program supportinthe patient-centered mission. 

When specialty care is referred, the Referral Management Center (RMC) is responsible for advising the patient of their benefits and working with the referring provider and the Managed Care Support Contractor to ensure that the referral is accurate and coordinate the referral with the specialty office, facilitating the recapture of Medical Treatment Facility (MTF) direct care capabilities, tracking the referral to closure, and returning all results of treatment to the patient's medical record. 

The Center serves as the one-stop shop for all referrals from the initiation of a referral to receipt of a clear, legible HIPAA compliant report is returned.

  • Review initial specialty care and deferred to network primary care referrals for administrative completeness (e.g., TRICARE operations, covered TRICARE benefit and required tests and pre-work.)
  • Coordinates with referring providers in cases where additional referral information is required.
  • Assist with ROFR determinations for specialty care 
  • Schedule specialty referral appointments 
  • Perform/assist with appointing network specialty care referrals as allowed 
    Coordinate with specialty referral clinics (e.g., internal MTF, ODCS, Veteran's Affairs clinic, etc) on special patient instructions and tests required prior to appointment.
  • Advise patients of the provider, location, time and day of referral appointments
  • Print diagnostic reports and treatment profiles if requested for patients to hand carry to a Network/non-network initial specialty care appointment.
  • Submit referrals to the appropriate reviewer when required for medical necessity and appropriateness review.
  • Advise all categories of patients of what their referral and health treatment options are as related to their eligibility and beneficiary status 
  • Track initial specialty care and deferred to Network primary care referrals to include obtaining reports from MTF, ODCS, network, and non-network providers.
  • Prepares monthly referral management data reports as determined by the MTF/Government.
  • Greet patients in a positive and professional manner, and provide appropriate patient education and instructions on their referral and the referral process. 
  • Provides patient education regarding specialty care referral, procedures, labs, etc to prepare the patient for their specialty care appointment/procedure.
    Facilitates professional and patient care activities.
  • Interfaces with the MCSC and MTF multidisciplinary personnel as needed to ensure appropriateness/completeness of referrals.
  • Conducts first level reviews for all referrals to specialty care.
  • Identifies cases that may benefit from alternative levels of care and involves the case manager as needed to provide direction in care management/coordination.
  • Provides nursing consultation and patient education on specialty care and patient's diagnosis.

 

Licensed Vocational Nurse (LVN) - RMC Job Qualifications:

  • Graduate from a NLNAC or CCNE accrediated program 
  • LVN License: any U.S. state honored. active, unrestricted. 
  • 2 years of healthcare administrative experience in either an inpatient or outpatient care setting within the last 3 years, highly preferred
  • TRICARE - working knowledge 

 

  • Knowledge and skills 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

 

 

 


FSRpeople.com

FSR provides healthcare professionals to government healthcare facilities supporting active military service members, retirees, and their families nationwide. Since 2004, FSR has matched talented individuals to organizations to create mutually beneficial, sustainable partnerships. FSR is a well-established, award winning organization built with committed professionals who have a unified vision of helping others to succeed and thrive. 

We invite you to join our team and grow with us!

FSR is a woman-owned, minority, small business based out of Maryland.

 

Federal Staffing Resources dba FSR is an Equal Opportunity Employer: disability/veteran/military spouse

This contractor and subcontractor shall abide by the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). These regulations 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. Moreover, these regulations require that covered prime contractors and subcontractors take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.

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FSR (Federal Staffing Resources)
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