Licensed Practical Nurse Referral Reviewer at Zimmerman Associates, Inc

QUALIFICATIONS/SKILLS AND EXPERIENCES:

Licensed Practical Nurse Referral Reviewers will be responsible for facilitating centralized product line and specialty referrals for Active-Duty Service Members and Tricare Prime beneficiaries enrolled to a Military Treatment Facility (MTF) in the National Capital Region.

This is an onsite employment opportunity. However, consideration will be provided for teleworking upon customer's approval.

QUALIFICATIONS/SKILLS AND EXPERIENCES:

• Minimum of an Associate’s degree, current, active full and unrestricted License Practical Nurse Certification/Licensure from an approved National League of Nursing program and 2 years of clinical nursing experience.

• Knowledge, skills, and computer literacy to interpret and apply medical care criteria, such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs) or other evidence-based guidelines identified by the Military Health System (MHS).

• Knowledge of medical terminology with an ability to learn MHS, VA-DOD Sharing Program, TRICARE, HIPAA, release of medical information.

• Effective communication and people skills.

• Superior customer service skills.

• Demonstrated knowledge and understanding of Access to Care Standards within the Direct Care System.

• Attention to detail and the appropriate use of deferral codes.

• Excellent organizational skills, i.e., ability to manage time effectively, prioritize tasks, set goals, and implement plans for achieving those goals.

• Knowledge of Microsoft Suite of Products, including Word, Excel, PowerPoint, Access, Outlook (email), and the Internet is required.