Clinical Admissions Liaison, LPN

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MedWatch, LLC

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1988

💼 Consulting

📦 Logistics

🛡️ Insurance

Consulting • Logistics • Insurance

MedWatch, LLC is a healthcare services company that provides utilization management, case management, disease management, member advocacy and concierge care coordination to payers, TPAs, and self‑insured employers. For over 35 years it has delivered clinically driven care management, precertification and claims solutions, direct contracting and ancillary services backed by URAC accreditations and proprietary in‑house technology to improve clinical outcomes and reduce plan and member costs.

📋 Description

• Assist the Case Management Department with clinical and clerical intake functions • Verify clinical and clerical information for active and potential Case Management cases • Monitor and process Case Management referrals and service approvals in concert with the Executive Director of Case Management • Assist Case Managers with case processing • Practice within the scope of licensure under the direct supervision of the Director of Case Management • Determine Case Management case-opening requirements based on service contracts • Collaborate with MedWatch departments to determine case-opening appropriateness and direction and obtain required information • Answer and prioritize incoming calls requiring clinical or clerical information • Answer customer questions and concerns or direct them to the appropriate person, office, or claims customer service team • Make outgoing calls to customers, providers, and patients to obtain necessary information • Obtain clinical, demographic, and related information from customers, providers, employees/patients, and employer groups • Enter clinical and demographic information into the computer data system • Maintain knowledge of URAC, state precertification, and company-specific contract requirements • Maintain and enter accurate program data • Maintain effective working relationships with customers, providers, employees/patients, employer groups, and MedWatch staff • Participate in the Quality Management Program and identify opportunities for service improvement • Assist with reconsiderations and appeals reviews • Assist with assigning cases to Case Managers • Assist with oversight of the admissions process and admissions staff

🎯 Requirements

• Licensed Practical Nursing Education • Licensed Practical Nurse license, current, active, and unrestricted, in the current state of practice and residence, within the United States or its territories • 5 years of varied clinical experience preferred, or 3 years in a specialty field • Good organizational skills and time management • Excellent verbal and written communication skills • Ability to handle difficult situations tactfully and diplomatically • Effective problem-solving and decision-making skills • Strong computer skills with proficiency in MS Office Suite products (Word, Excel, PowerPoint) • Leadership skills a plus • Ability to work in the United States for any employer without sponsorship • Dedicated, quiet workspace in the home

🏖️ Benefits

• Paid time off • Medical insurance • Dental insurance • Vision insurance • Short-term disability • Long-term disability • Life insurance • AD&D insurance • 401k with match • Critical illness coverage • Legal plan • Identity theft coverage • Pet insurance • Discount programs • Remote work / home office environment