Allegiance Benefit Plan Mgmt.
  • 14-Dec-2018 to 31-Jan-2019 (MST)
  • Las Vegas, NV, USA
  • $20-$22 DOE
  • Hourly
  • Full Time

Full Benefit Package


Do you want a career where you can make a difference? Allegiance is a growing company with hometown values that is looking for dynamic candidates to join the team! A positive, team-oriented environment is provided with opportunities for advancement.

Allegiance offers full-time positions with evenings, weekends, and holidays off and a multi-faceted benefits package.

We pride ourselves in having a reputation for top-notch customer service. Make a difference. Start your career with Allegiance today!

 

REPORTS TO:   Case Management Services Manager         LOCATION: Missoula        FSLA STATUS: Hourly

 

POSITION RESPONSIBILITIES: 

This position assists with the evaluation of medical care alternatives for cases of illness, injuries or medical/surgical diagnoses that require extensive services.  These cases may require acute rehabilitation, in-patient hospitalization, or preventive care in an attempt to avoid future complications or admissions.  This role of the LPN is to facilitate quality health care by decreasing fragmentation, enhancing the patient's quality of live, while containing costs, resulting in more effective outcomes.  The roll will also serve as a support when screening for case management services and may be responsible for the liaison to steering to disease management programs.

 

The incumbent is expected to communicate professionally with peers, supervisors, subordinates, vendors, customers, and the public, and be respectful and courteous in the conduct of this position.

 

 

ESSENTIAL JOB FUNCTIONS:

Essential job functions include the following.  Other functions may be assigned as business conditions change

 

  • Completes clinical assessment and determines who may qualify for case management based on clinical judgment, changes in members health and triggers from assessment
  • Able to screen claims triggers for case management needs and make referrals to disease management and chronic care program
  • Pre and post care planning on surgical admissions
  • Facilitates discharge planning follow up calls and screens for and initiates referrals for chronic care management program
  • Able to effectively initiate and return telephone messages independently, as evidence by individual compliance with Quality Assurance (QA) requirements.
  • Provide accurate information to callers as evidenced by software entry/documentation.
  • Compliance with protocols and QA requirements.
  • Able to function as training preceptor as evidenced by completion of trainee checklist.
  • Participates in team meetings, committees, or committee assignments as evidenced by:
    • Completion of tasks assigned by team or committee.
    • Completion of team QA evaluation in compliance with QA protocol; and
    • Knowledge to present and participate in provider/subscriber and group services, workshops, and educational seminars.
  • Maintains current clinical knowledge and skills through the attendance of seminars, available Internet education, written works, or other similar resources on a biennial basis as evidenced by a documented 24 CEU hours during a two year renewal period as recognized by the State Board of Nursing.
  • Participate in the screening, communication and coordination of the disease management program as assigned.
  • Review letters on a daily basis
  • Performs other duties and job functions as assigned.

 

NON-ESSENTIAL JOB FUNCTIONS:

 

  • Preparation of forms, faxing, copying.
  • Organizion of files and referance materials.
  • Ability to operate typical office equiptment and working knowledge of basic office practices.

 

PHYSICAL WORKING CONDITIONS:

Physical requirements are representative of those that must be met to successfully perform the essential functions of this position.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Sitting                   80%                                                    Reaching                     Minimal

Standing                10%                                                    Manual Dexterity        Ability to type/keyboard

Walking                 10%                                                    Telephone                    High Degree

Kneeling                As needed                                          Computer Screen        High Degree

Bending                As needed                                          Lifting                         25 pounds

 

 

JOB SPECIFICATIONS:

To perform this position successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Education and Licensure:                                   Current licensure as a Licensed Practical Nurse LPN or Licensed Vocational Nurse LVN.

                                                                              At least one year experience

 

Other Experience:                                               Must possess organizational skills and the ability to prioritize multiple tasks, attend to detail and follow through to completion.

Full Job Description
Allegiance Benefit Plan Mgmt.
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