Spectrum Healthcare Resources is excited to offer a potential career opportunity for an LPN Care Coordinator supporting TRICARE beneficiaries. This civilian position is an outstanding chance to contribute to the health and well-being of military members and their families while enjoying a rewarding work-life balance and a supportive patient community.
Individuals must be able to work 11:00 PM – 7:30 AM PST and must reside in the Pacific Time Zone (PST), Alaska, or Mountain Time Zone (MST).
Requirements:
- Active, unrestricted Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) license in any U.S. state or territory.
- Minimum of two (2) years of clinical nursing experience.
- Proficiency in medical data entry, written skills, and Microsoft Office.
- Exceptional oral communication and organizational skills, with the ability to adapt to change.
Preferred Qualifications:
- Three (3) years of clinical experience.
- Two (2) years of Managed Care experience.
Job Responsibilities:
- Utilize clinical and analytical skills to identify care coordination needs and facilitate care transitions.
- Communicate with community providers, TRICARE beneficiaries, Military Treatment Facilities (MTFs), Veterans, VA Medical Centers (VAMCs), and other healthcare facilities to coordinate care.
- Ensure proper authorizations are in place to meet clinical care needs.
- Accurately document coordination activities in the Medical Management System (MMS).
- Refer cases to other TRICARE programs as needed.
- Participate in Quality Improvement Projects as indicated.
- Identify and report potential quality or fraudulent cases to Clinical Quality and/or Program Integrity.
- Maintain regular and reliable attendance.
- Perform other duties as assigned.
Competencies:
- Strong knowledge of internal policies, utilization management principles, managed care concepts, medical terminology, and clinical decision support tools.
- Problem-solving and analytical skills to evaluate processes and make sound judgments.
- Organizational skills to prioritize tasks, meet deadlines, and adapt to evolving systems.
- Empathy and customer service skills to provide compassionate support to beneficiaries.
- Ability to remain flexible and resilient in adapting to changes and working in a fast-paced environment.
- Proficiency in Microsoft Office and multi-system environments, including Teams, Outlook, and internal medical management software.
- Strong communication and interpersonal skills to collaborate effectively.
- Commitment to policies and procedures, demonstrating high personal motivation.
Working Conditions:
- Availability to work any shift, including nights and weekends.
- Remote or office-based work environment.
- Extensive phone and computer work with prolonged sitting.
- Department of Defense security clearance required.
Company Overview:
Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. EOE/Disabled/Veterans
