What are the responsibilities and job description for the Clinical - LTSS Care Navigator position at Pyramid Consulting, Inc?
Job ID: 25-63049
Pay Range: $19 - $21/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
- The Specialty Authorization Team consists of the processing of authorizations and follow-ups for DME, MHM, DAHS, and reductions/denials in which we are now at a 1 BD TAT for the processing of SK/SH/MMP authorizations.
- We utilize project temps/contingent workers to assist with each of these areas as well as cross train them to be able to assist in multiple functions.
- The team continues to experience high authorization volumes.
- We work together like a family rather than co-workers in which helps facilitate the best care for those we serve by being committed, flexible, and compassionate to enhance the lives of each and every Member.
- Daily check in & communication via group IM(s)
- Daily production logs must be completed and emailed to designated person no later than 9am next business day
- Multi-tasking with multiple monitors and applications
- Utilize work guides and or resources
- 97% Quality (Audits)
- 98% Production
- 0-5% Error Rate
Key Requirements and Technology Experience:
- Key skills; Managed Care
- LPN/LVN
- Working with disabilities.
- 2 years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions.
- Microsoft office experience
- Time Management
- Must haves: 2 year of experience in managed care/working with disabilities. LPN, LVN, or LCSW preferred. License is the most important.
- Nice to haves: Licensure listed above, Microsoft Office experience
- Disqualifiers: n/a
- Performance indicators: n/a
- Education/Certification Required: LPN, LVN, or LCSW preferred.
- License is the most important.
- Education/Certification Required: High School/GED
- Preferred: Bachelor’s degree in Social Work, Health Services, Behavioral Science, or related field, or equivalent experience.
Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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Salary : $19 - $21
