Registered Nurse (RN) / Licensed Practical Nurse (LPN) (Eglin AFB, FL
Ivyhill Technologies LLC
Eglin Air Force Base, florida
Ivyhill is seeking Registered Nurses (RN) / Licensed Practical Nurses (LPN) for a project in the Eglin AFB, FL area. The qualified RN will provide Referral Management (RM) activities include timely processing of Right of First Refusal (ROFR) requests, screening of specialty care referrals, sustaining up- to-date Specialty Clinic Booking Guidance, Military Treatment Facility (MTF) Capabilities Report, ROFR Reports, maintaining up-to- date MTF/Managed Care Support Contract (MCSC) Memorandums of Understanding (MOUs), comply with Referral and Authorization Business rules, tracking, accounting, and resulting of referrals, and full use of RM information management systems. Will conduct reviews for medical necessity, pre-authorizations, medical appeals, collection and recovery from insurance carriers, and right of first refusal activities. The LPN will provide utilization management activities in the Referral Management Center.
Requirements
The...