LPN I

LPN I

Requirements

• Active Unrestricted NJ LPN License Required
• Prefers an Associates degree from an accredited college or university in health care management or related field
• Requires a minimum of one-year clinical experience in an acute care facility
• Requires a minimum of one-year experience in the health care delivery system/industry
• Required knowledge of medical terminology

Responsibilities

• Assesses patient-s clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay.
• Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided.
• Coordinates and assists in implementation of plan for members.
• Monitors and coordinates services rendered outside of the network, as well as outside the local area, and negotiate fees for such services as appropriate.
• Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care.
• Monitors patient-s medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness.
• Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided.
• Encourages member participation and compliance in the case/disease management program efforts.
• Documents accurately and comprehensively based on the standards of practice and current organization policies.
• Interacts and communicates with multidisciplinary teams either telephonically and/or on site striving for continuity and efficiency as the member is managed along the continuum of care.
• Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.
• Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
• Performs special projects as assigned by management.
• Conducts preventive health screenings and documents health data related to specific preventive screening.
• Responsible for educating and enrolling potential members into HNJH products through marketing.
• Serves as a representative at company sponsored community events and coordinates all on-site responsibilities.

Preferred Qualifications

• Prefers quality initiative experience
• Prefers knowledge of managed care principles