The contractor shall provide Referral Manager/LVN type of care to treat and/or support the treatment of the patients of the 31st Medical Group, Aviano Medical Treatment Facility (MTF).
The Contractor shall perform a full range of duties consistent with their labor category, education, training, experience, clinical privileges (as applicable) and assigned position.
Have complete follow-through with each referral from beginning to end.
End includes the Clear and Legible Report (CLR) being uploaded within the current medical database and the referral closed with the t-con sent to the patient's PCM.Assists patients via phone, in person with their referrals and ensure patients have a thorough understanding of the referral process to ensure expectation management of all patients.Maintains a professional relationship and consistent communication with the provider staff and with colleagues in the TRICARE Operations and Patient Administration (TOPA) work environment to ensure processes are managed and streamlined for optimal referral management.Maintains current access to all databases required for daily operations and be proactive to ensure there is no lapse in database access.Coordinates referral management functions and ensures team members receive information in a timely and efficient manner to facilitate continuity of patient care.Coordinates specialty care referrals.
Specialty Care routine referrals must be processed within the Access to Care Standard of 28 days per Air Force Manual 41-210.
Urgent/ASAP referrals must be processed immediately, but not longer than 24 hours within a business day.
All patients shall be assured of their privacy and personal dignity (per section 4.13).Reviews specialty care referrals for appropriateness, covered benefit, and administrative and medical completeness.Makes specialty care appointments and provides pre-appointment instructions to patient.Provides health benefits advice to patients.Maintains and tracks referral records.Participates with team members in providing, assessing and improving a wide variety of customer services/relations.Assists in the management of all forms of communication between beneficiaries, team members, internal staff and providers, network/outside providers and ancillary health care workers.Prepares and submits administrative reports and uploads a patient Clear and Legible Report into the patients' medical record with a t-con sent to the patient's provider.The Contractor shall attend meetings and training as directed by the TOPA Flight Commander or his/her designee.
The Contractor shall attend any additional special meeting called by the 31 MDG Commander or his/her designee, as required.Be productive and perform with minimal supervisory direction.Display professionalism and positive/cooperative attitude.Provide patients with the utmost care and attention.
All patients shall be assured of their privacy and personal dignity.Maintain an open and professional communication and conduct with members of the MTF staff.
Complaints validated by the Chief of Medical Staff or TOPA Flight Commander shall be reported in writing to the contract administrator and the immediate supervisor for action.
Failure of the contracted Referral Manager to correct validated complaints raised by the MTF staff and the contract administrator will be considered a failure to perform.Prepare all documentation to meet or exceed established standards of the MTF, to include, but not limited to, timeliness, accuracy, content and signature.
Only MTF and Air Force-approved abbreviations shall be used for documentation of the patient health record.Present a professional, conservative, and neat appearance.Report for duty in a professional manner, in appropriate attire befitting a health care setting, and having complied with socially acceptable standards of personal hygiene expected of health care workers.
EDUCATION AND TRAINING Associate Degree in Licensed Vocational Nurse, Business Administration, Management or Health Care Organizations from an accredited college or university.License.
Have, as a minimum, a current LVN certificate from an accredited national, state or military trained equivalent school.
The licensed vocational nurse shall have and maintain an active, valid, current, unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a LVN in a US jurisdiction.
Maintenance of required certification is mandatory.The Contractor shall be in good standing, and under no clinical restrictions, with the state license board in any state in which a license is held or has been held within the last 10 years.Experience working within the Air Force Medical Service or DoD is preferred (3-5 years in a specialty area).
Consideration will be given to those who have completed medical-related college-level coursework.
ADDITIONAL QUALIFICATIONS A current Basic Life Support (BLS) certification is a job requirement.Language Requirement.
The Contractor shall read, understand, speak, and write English fluently.The Contractor must be knowledgeable in medical privacy and confidentiality (Health Insurance Portability and Accountability Act (HIPAA)); accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC) and The Joint Commission (TJC).Computer applications/software to include Microsoft Office programs, MS Outlook (e-mail), and internet familiarity is required.The Contractor must be skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous.The Contractor must possess organization, problem-solving and communication skills to articulate medical requirements to patients, families/caregivers, medical and non-medical staff in a professional and courteous way.
#J-18808-Ljbffr
