Quality and Innovation Licensed Practical Nurse; LPN - Manning - Quality

Position: Quality and Innovation Licensed Practical Nurse (LPN) - Manning - Quality
JOB PURPOSE:

The Quality and Innovation - Licensed Practical Nurse (LPN) serves as part of the Quality team. In this role, the Quality and Innovation LPN will be responsible for managing and facilitating the authorization process for prescribed medications. The QI LPN will also promote and ensure medication adherence among patients. This role involves working closely with healthcare providers, insurance companies, and pharmacies to ensure timely approval and accessibility of medications for patients.

The Quality and Innovation LPN position plays a pivotal role in advocating for patients' medication needs and navigating the complexities of medication authorization. The position requires a skilled and compassionate LPN who can collaborate with healthcare teams, educate patients on medication regimens, and monitor and assess medication compliance. The Quality and Innovation LPN will participate in quality improvement initiatives related to medication adherence, medical prior authorizations, and other quality improvement projects as assigned.

The employee in this position routinely works with general supervision and review, and any work problems involving departures from scope of practice, standard policies, interpretations, or procedures are reviewed with the supervisor for resolution or direction.

Essential Job Functions:

Ability to perform and/or complete all assigned duties, tasks, responsibilities, and assignments for a Quality Licensed Practical Nurse within reasonable time frames while meeting established rates of performance for the position, ensuring the highest standards of excellence and the lowest of error rates in your work performance.
Maintains a clean, safe, and hygienic work environment in compliance with all Policies and Procedures to include, but not limited to work areas, workstations, examination rooms, hand washing, etc. as required for a Licensed Practical Nurse.
Maintains patient confidentiality by controlling the environment and information being disclosed to authorized individuals ensuring HIPM and corporate compliance requirements at all times.
Understands and complies with all organizational Code of Conduct standards, Policies and Procedures, Standing Orders, and Service Excellence requirements at all times with all patients, visitors, and employees.
Ensures a work environment safe and free from hazards; immediately address or inform management of safety issues or hazards; adhere to Health and Safety Policies and Procedures; participate in all safety programs, which may include assignment to an emergency response team.
Develops and implements strategies to improve patient compliance with medication regimens.
Provides resources and information to help patients overcome barriers to adherence.
Collaborates with physicians, nurses, and other healthcare professionals to address patient-specific medication adherence challenges.
Communicates effectively with patients and their families to address questions, concerns, and provide ongoing support.
Initiates and manages the medication authorization process, obtaining necessary approvals from insurance providers for prescribed medications.
Communicates with healthcare providers to gather required documentation and information for authorization submissions.
Works closely with pharmacies to facilitate prescription refills and ensure timely delivery of medications.
Works closely with payers to communicate med adherence completions and ensure accurate reporting.
Verifies patients' insurance coverage and determine the specific requirements for medication authorization.
Collaborates with insurance companies to obtain prior authorizations for medications and address any coverage-related issues.
Addresses and resolves any issues or challenges related to medication authorization promptly.
Demonstrates at all times a professional attitude and acceptable job performance for all duties, tasks, responsibilities, and assignments for this position at any location or assignment that supports the operational needs of El Rio Health and as assigned by organizational leadership.
Evaluates problems, situations, or issues presented to the employee (whether in a clinical or non-clinical environment) for priority needs, resolving the problem effectively and in a timely manner using critical thinking and problem-solving skills appropriate to the position and authority for a Licensed Practical Nurse.
Demonstrates an understanding of and proficiency with the application of all compliance and reporting requirements respective to Joint Commission Accreditation standards for a Licensed Practical Nurse.
Identifies and reports any safety hazard, or potential hazard, by directly notifying supervisory staff immediately and ensuring that El Rio facilities provide a safe and secure environment for all patients, visitors, and employees; adhere to Health and Safety Policies and Procedures; participate in all safety programs, which may include assignment to an emergency response team.
Communicates…