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Registered Nurse (RN) - Referral Management

Tacoma, WA

Details

Hiring Company

FSR

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Position Description

Registered Nurse (RN) - Referral Management job in Tacoma, Washington.

  • Any U.S. state license
  • Civilian position supporting military healthcare

Benefits:

  • Health and Welfare Benefits
  • 401(k) available
  • Paid Time Off
  • Paid Holidays
  • Paid Sick Time
  • LTD, STD, and medical, dental, life, and vision options available

Registered Nurse (RN) - Referral Management Job Overview:

  • Civilian and military healthcare providers work together to provide a full range of services to the military community.
  • The Referral Management Center (RMC) serves as the primary point of contact for patients' referrals
  • Review initial specialty care and deferred to network primary care referrals for administrative completeness
  • Coordinate with specialty referral clinics.
  • Submit referrals to the appropriate reviewer when required for medical necessity and appropriateness review.
  • Track initial specialty care and deferred to Network primary care referrals to include obtaining reports from MTF, ODCS, network, and non-network providers.
  • Provides patient education regarding specialty care referral, procedures, labs, etc to prepare the patient for their specialty care appointment/procedure.
  • Facilitates professional and patient care activities.
  • Conducts first level reviews for all referrals to specialty care.
  • Identifies cases that may benefit from alternative levels of care and involves the case manager as needed to provide direction in care management/coordination.
  • Provides nursing consultation and patient education on specialty care and patient's diagnosis.

Registered Nurse (RN) - Referral Management Job Qualifications:

  • 5 years of broad based clinical nursing experience - highly preferred
  • Utilization Management nursing experience - highly preferred
  • TRICARE - working knowledge
  • Knowledge and skills to interpret and apply medical care criteria, such as InterQual or Milliman Ambulatory Care Guidelines.
  • Working knowledge of APGs, DRGs, ICD-9, and CPT-4 coding
  • Quality Control and Risk Management experience
  • Excellent oral and written communication skills and interpersonal skills
  • Working knowledge of computers (Internet, Microsoft Word, Microsoft Access, Microsoft Excel, and Windows)
  • HIPAA knowledge
  • Graduate from an ACNE or CCNE accredited program
  • RN License: any U.S. state honored. active, unrestricted.

#FSR123

FSRpeople.com

FSR provides healthcare professionals to government facilities supporting active duty military service members, retirees, and their families. FSR began as a women-owned, minority-owned, small business in Maryland and has grown to an award-winning organization serving the federal government nationwide and around the globe.

We invite you to join our team!

Federal Staffing Resources dba FSR is an Equal Opportunity Employer: disability/veteran/military spouse

This contractor and subcontractor shall abide by the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). These regulations prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity or national origin. Moreover, these regulations require that covered prime contractors and subcontractors take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.


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