Employment Opportunities
Purchase Referred Care (PRC) Contract Health Referral Specialist
This position has been filled.
Public?:
Public
Division:
Health
Reports To:
PRC Director/Case Manager
Type of Position:
Regular Full Time
Location:
Little Axe Health Center / 15951 Little Axe Dr. / Norman, OK 73026
General Description
This position is located within the Absentee Shawnee Tribe's Health Programs at the Little Axe Location. This position serves as a PRC Referral Specialist/LPN for all referrals placed from providers. Will be responsible in ensuring all steps are taken in regards to referrals, address communications between the patients and the providers to whom/what the patients have been referred. Responsible for problem solving on issues regarding referrals. The incumbent is under the administrative supervision of PRC Director and/or Case Manager.
Responsibilities
Primary Duties include, but not limited to:
Manage eligible patients seen in the Little Axe Clinic requiring addition medical care as notated by the provider referral.
Provides information in person or by telephone regarding services available under the Absentee Shawnee Tribe's Health Clinic.
Responds to PRC/CHS inquiries and requests for PRC/CHS assistance. Such responses are through telephone, correspondence, and personal visits with customers/patients.
Communication with other interdepartmental PRC staff regarding referrals received from providers.
Develops and maintains a positive working relationship and supports the overall team effort of the Absentee Shawnee Tribal Health program providers including clinics, physicians, community outreach programs, third party resources, community health care nurses, home health care nurses, diabetes initiative, behavioral health, billing office, health board and PRC/CH review committee.
Documentation, processing and auditing of provider driven referrals
Utilizing IHS, Private Insurance, Medicaid/Medicare, and Tribal Health Programs.
Enters client data into the appropriate database; maintains accurate files, and organizes data.
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Performs other duties as assigned.
Education Requirements and Qualifications
Knowledge, Skills and Abilities
Incumbent must possess the ability to interact with a wide variety of individuals and handle several complex situations simultaneously. It also requires impeccable communication and negotiation skills, written and
verbal, and excellent computer and typing skills. Must be able to provide quality customer service. Must be able to apply critical thinking through the ever changing work environment. Knowledge of software to access and interpret patient data.
Excellent verbal and written communication skills.
Ability to communicate with patients, families, caregivers and other healthcare professions.
Culturally sensitive to Native Americans.
Good organizational and assessment skills.
Self-motivated.
Must be able to prioritize work tasks and be creative with projects.
Must be able to fully utilize a computer.
Must be able to perform duties with a minimum of supervision.
Must be able to function as a team member.
Must be able to be a dependable team member of the clinic setting and be ready to start work on time.
Must be able to be sedentary for long periods of time, will require a majority of sitting time.
Must be able to work in an office setting with public interaction and exposure to potential illnesses.
Must possess a valid Oklahoma Driver's license.
Must be able to pass a background check and drug screen.
QUALIFICATIONS
High School graduate; some college preferred.
Licensed in Oklahoma as Licensed Practical Nurse (LPN) in good standing preferred; will also consider Medical Assistant (MA) with Certificate and experience.
Minimum completion of a program or training in Medical Office Technology or a related field.
Must be familiar with medical terminology.
Experience with prior authorizations, insurance pre-certifications a plus.
Experience with electronic health record (EHR) software preferred.
PHYSICAL REQUIREMENTS AND WORKING CONDITIONS
Must be able to sit, stand, stoop, bend or kneel for long periods of time.
Sitting, standing or walking for long periods of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling needed; frequent repetitive motions; talking, hearing and visual acuity.
Frequent lifting up to 15 pounds.
Occasional lifting up to 30 pounds.
Native American Preference/EEO/Smoke Free/Drug Free Workplace
Posted Date:
1 year 9 months ago