Spectrum Healthcare Resources has a potential opportunity for a Full-Time Referral Management Medical Administration Specialist at Tripler Medical Army Center in Honolulu, Hawaii.
Position offers :
- Full-time position | 40 hours per week
- Monday through Friday schedule
- Benefits to include medical, dental, vision, 401k, paid time off and more
Position Requirements :
A bachelor’s degree in health care administration, business, information management, or a related discipline is required. Master’s Degree is one of these areas is preferred.At minimum of 10 years of medical administration services is required. (Equivalent combinations of education and experience may be qualifying if approved by the requesting location and the Contracting Officer)Mastery level knowledge of military Medical Services, civilian health care delivery systems, military management health care principles and techniques, TRICARE Managed Health Support contracts and clinical and financial systems, policies, procedures and standards as well as knowledge of DoD, Air Force, Army or Navy and Accreditation Association of Ambulatory Health Care (AAAHC) standards and privacy and confidentiality requirements (HIPAA).Position Responsibilities :
Oversee and monitor the review, coordination, and tracking of Virtual Healthcare referrals, urgent / ASAP referrals, and VA-DOD sharing referrals. This position will monitor the clinical workflow of the VH Case Manager(s)Develop and provide periodic executive-level briefings to local, regional and DHA leadership when required.Perform business development review for future GTP platform expansion for both administrative and technical integration. Provide program management technical support, analysis, and data management to sustain the operational computing environment for the GTP program.Advise on Information Management / Information Technology projects affecting clinical operations IAW current DHA, service and MTF policies, workflows, and business practices.Identify issues with the system and formulate detailed change requests to address identified defects.Perform Quality Management audits and gap analysis to ensure cases are being processed IAW HIPPA regulation. In addition, identify trends and demands for administrative and clinical support or services. The contractor shall develop system documentation and training material including, but not limited to User Guides and Standard Operating Procedures. Conduct training as needed for both clinical and administrative users on system usage in person and remotely.Perform IAM (Identity Access Management) for the GTP platform. When needed, create new accounts, and deactivates old accounts from VH platforms. Provides basic customer service to system users who are having technical issues with the platform and have basic service needs such as password resets via GSC ticketing system.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.
Spectrum Healthcare Resources is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
position at the Triper Medical Army Center in Honolulu, Hawaii.
Highlights : Ind.N urse
Full-time | 40 hours per week (Monday-Friday)Emphasis on work-life balance (this is a remote position)2 weeks paid time off & 11 paid federal holidaysEmployee status with full complement of benefitsResponsibilities :
Will provide utilization management activities in the Referral Management Center.
Receives all reports and makes a determination regarding referring consults, drug treatment protocols, etc.
Sends treatment plans to primary care providersMonitors end of day processing for data qualityNotifies physicians of abnormal test results within a defined time frameRequirements :
Graduate of a school of practical or vocational nursing
6 years of clinical nursing experience is required. Previous experience in Utilization Management is not required. Full time employment in a nursing field within the last 36 months is mandatory.
Equivalent combinations of education and experience may be qualifying if approved by the requesting location and the Contracting Officer. If education or experience is used to meet the specialized requirements of this position, it must be directly related to referral / utilization managementmust have a working knowledge of Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), International Classification of Diseases-Version 9 (ICD), and Current Procedural Terminology-Version 4 (CPT-4) coding.Active, unrestricted nursing license in any state
BLS from the American Heart AssociationFor Further Information, please contact :
Judi Brown, Recruiter IIEmail : Judi_Brown@Spectrumhealth.com314-744-4135US-HI-Honolulu
Judi Brown
314-744-4135
Judi_Brown@spectrumhealth.com Learn More
