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Licensed Practical Nurse​/LPN​/Licensed Vocational Nurse​/LVN

Job in Misawa - Japan
Full Time, Contract position
Listed on 2020-10-26
Job specializations:
  • Nursing
    LPN/LVN, Clinical Nurse Specialist
  • Administrative/Clerical
Job Description & How to Apply Below
Position:  Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN)
We are seeking experienced LPN/LVN to work at Misawa, AB, Japan

General Description:
LPN/LVN shall provide clerical/administrative support in the RMC for customer service, referral tracking, referral appointing, and reporting activities.  This position will support the daily functions of specialty care referral appointing, referral review and coordination, beneficiary counseling and referral tracking at the Medical Treatment Facility (MTF).  Ensuring Referral Management (RM) activities comply with Referral and Authorization Business rules, tracking, accounting and resulting of referrals and full use of RM information systems.

Specific Tasks:
• Reviews referrals for administrative, clinical completeness and appropriateness in coordination with the Chief, Medical Staff (SGH) or deputy SGH.  Completes medical necessity and benefit reviews on referrals and makes recommendations to the MTF approval authority for approval/disapproval of the specialty care requested.  Coordinates with the TRICARE Overseas Program contractor as needed to determine availability of local care.
• Schedules referral appointments in accordance with Air Force Access to Care (ATC) standards with DoD and civilian health care providers.  Ensures appointing is done within the Access to Care standards.  Notifies the MTF group practice manager, TRICARE Operations and Patient Administration Flight or SGH if ATC standards are not met for referrals.
• Coordinates with specialty referral clinics to obtain special patient instructions and/or tests required prior to appointment.  Provides pre-appointment instructions to patients as well as the details regarding their referral appointment (i.e., date/time, provider, and location).  Ensures patients receive necessary documentation appropriate for the referred medical care visit.
• Interfaces with the TRICARE Overseas Program contractor, SGH and multidisciplinary personnel as needed to ensure appropriateness of referrals.  Submits referrals from civilian providers to the TRICARE Service Center (TSC) for medical necessity and appropriateness review.
• Locates referral requests and ensures appropriate documents are available prior to all specialty appointments. Prints diagnostic reports and/or treatment profiles as necessary.
• Receives and makes patient telephone calls and computer/written correspondence regarding specialty clinic appointments and referrals.  Routinely monitors referral management CHCS queue to ensure patients are being called that do not utilize the Referral Management Center (RMC) walk-in service.
• Contacts patients in the event referral requests are invalid, disapproved by second level review or TRICARE Overseas Program contractor and reschedules patients as soon as possible or instructs patients of other health care options.
• Answers, completes and/or appropriately forwards patient or provider telephone calls.
• Coordinates with patient movement office to advise patients of their referral/health treatment options as related to their eligibility per beneficiary status and covered benefits.
• Verifies eligibility of beneficiaries using Defense Eligibility Enrollment Reporting System (DEERS).
• Works in collaboration with TRICARE Operations and Patient Administration (TOPA) staff, providers, utilization manager (UM), case managers (CM), disease management (DM) nurses, special needs coordinator, health care integrator and group practice manager to determine measures to target and manage enrollees and/or processes that relate to high-cost, high-volume or problem-prone diagnoses, procedures, services and beneficiaries who have demonstrated high utilization rates.  Uses the TRICARE Management Activity Medical Management Guide in performance of these duties.  
• Documentation.  You shall prepare all medical documentation to meet or exceed the standards required under applicable Air Force Instructions and the Joint Commission (TJC) guidelines.
• Work Environment/Physical Requirements.  The work is primarily sedentary.  However, there may be some physical demands.  Requirements include standing, sitting or bending. You are required to walk throughout facility to interact with staff and providers including transport of relevant documents.
• Information Technology Systems (ITS).  CHCS, AHLTA, CarePoint and the Integrated Clinical Database (ICDB) programs must be used for case management services.
• Utilizes MTF performance improvement tools in data collection and identifies barriers to the achievement of improvement in multidisciplinary treatment teams and/or clinical programs.
• Complies with requirements, and assists clinical programs and treatment teams in preparation for The Joint Commission (TJC), National Committee for Quality Assurance accreditations; the Air Force Inspection Agency Health Service Inspection; Air Force Audit Agency audits and other internal or external reviews, as applicable.
• Must comply with Air Force Equal Opportunity and safety policies and procedures.
Position Requirements
Bachelor,   Less than 1 Year work experience
• The minimum education requirement is graduation from a State Board of Nursing approved LPN/LVN training program or completion of equivalent United States military training that permits sitting for a state licensure examination.

• Minimum of six (6) months of clinical nursing experience within the last 5 years is required.

• Must possess a current, valid and unrestricted license in one of the 50 states and/or the District of Columbia, the Commonwealth of Puerto Rico, or territories of the United States.  All licenses must meet all state requirements, be unencumbered and remain in effect during contract employment.  

• Must be capable of performing the full range of services commensurate with the degree and/or professional license held.  
• Must have a working knowledge of Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), International Classification of Diseases-Version 9 (ICD-9), Current Procedural Terminology-Version 4 (CPT-4) coding and InterQual or Milliman Ambulatory Care Guidelines.  
• Working knowledge of computer applications/software to include the Windows Operating System, Microsoft Office word processing, database and spreadsheet programs and internet familiarity is required.  
• Ability to input, extract and format data from multiple electronic sources is also required.
Required Language Skills:
  • English - Very good
Contact Information
Contact Name: Entourage Consulting LLC
Contact Phone: 210880-4802
Preferred method of contact: Email with CV via Application Box below.
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