20 days old

Care Senior Associate - LPN - Philly Market

828 Newquest LLC
Philadelphia, PA 19107
  • Job Code

Position Summary

The Care Coordinators receive written and verbal referrals from Nurse Practitioners, contact contracted providers (physicians and ancillary suppliers), set appointments, coordinate transportation, and initiate written notices to members, responsible parties, providers, transportation companies, and nursing facilities.The position coordinates the care ordered by I-SNP Nurse Practitioners and communicates to all impacted parties the status of the referrals and care ordered.

Essential Duties and Responsibilities

  • Respond to written and verbal orders from Nurse Practitioners by coordinating the care ordered by the Nurse Practitioner for the C-HS member including performing as liaison between members, community-based resources, and health care institutions to assist in the coordination of benefits, such as Medicare and Medicaid that members are eligible to receive.
  • Contact physician and specialty providers and obtain appointments for C-HS members.
  • Contact ancillary providers and coordinate the delivery of durable medical equipment (DME) for C-HS Members.
  • Contact and coordinate transportation for C-HS members residing in nursing facilities to physician and specialty providers.
  • Assists the care management team in ensuring that member transitions of care between various settings such as hospitals, skilled nursing, and rehabilitation facilities are managed appropriately.
  • Initiate and finalize written documentation (letters) to the C-HS Member, Responsible Parties, Nurse Practitioners, Physician, Specialty Provider, Transportation Company and/or ancillary providers. Mail or fax the written communication.
  • Documents and track all clinician orders in department systems.
  • Follow up on specialty orders requiring Pre-certification (or authorization) to insure certifications and authorizations are timely and effectively communicated.
  • Interact telephonically with Nurse Practitioners and Nursing Facility Staff.
  • Attend department meetings and participate appropriately.
  • Performs other related duties as assigned.
  • Respond and process referrals within timeframes established by department standards.

Minimum Qualifications

  • High School diploma or equivalent required.
  • LPN required.
  • Computer proficient in Microsoft Office programs and ability to learn other programs as established by C-HS.
  • Willing to travel as needed.
  • Understanding and empathy for the frail elderly and their families.

Knowledge, Skills, and Abilities

  • Excellent listening, organizational and attention to details skills.
  • Ability to meet deadlines and manage multiple priorities.
  • Effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environment
  • Ability to handle confidential information with professional ethics and integrity.
  • Ability to formulate and write professional correspondence.
  • Strong organizational skills.
  • Must be able to work well with all levels in the organization.
  • Must be able to communicate with nurse practitioners, physicians, provider office staff, and nursing home staff.
  • Ability to multi-task.
  • Excellent oral and written communications skills with strong analytical and problem solving skills.
  • Able to operate PC-based software programs.
  • Ability to take direction/feedback.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Posted: 2020-01-08 Expires: 2020-02-06
Sponsored by:
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Sponsored by:
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Care Senior Associate - LPN - Philly Market

828 Newquest LLC
Philadelphia, PA 19107

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