Licensed Practical Nurse (LPN)

Licensed Practical Nurse – Referral Management Center Minimum Qualifications Degree: Certificate. Education: Graduation from a State Board of Nursing approved LPN / LVN training program or completion of equivalent military training that permits sitting for the State licensee exam. Experience: Current experience required is one year in the last two years as a practical or vocational nurse. License: Current, full, active and unrestricted license as a practical or vocational nurse. Core Duties Review referrals for administrative, clinical completeness and appropriateness. Validate required medical services, authorize surgery/medical procedures, laboratory, radiology, pharmacy, and general hospital procedures and regulations; collaborate with TRICARE regional Office Clinical Liaison Nurse and MTF. Liaison to address any process issues or concerns. Schedule referral appointments in accordance with required Access to Care Standards within the direct care system or outside the MTF within network/non-network providers for 90% of all referrals. Provide timely, descriptive feedback regarding utilization review issues. Review and enter first right of refusal referral into CHCS and database within one (1) business day of the date of the referral. Submit referrals to non-network providers to TRICARE Service Center (TSC) for processing. Receive and make patient telephone calls and computer/ written correspondence regarding specialty clinic appointments and referrals. Track referral reports; obtain referral results within the required timelines and follow up as necessary; document that paper referral results are properly filed in patient’s health record. #J-18808-Ljbffr GCP-Inc