Additionalinformation

Additional Information

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Companydescription

Company Description

Support specialty care coordination within a military healthcare environment where clinical judgment, referral management, and patient education help ensure beneficiaries receive timely access to appropriate care.

At International SOS Government Medical Services, you'll support healthcare programs that improve patient care and operational readiness across the U.S. and internationally. Founded in 1984, International SOS operates in more than 90 countries, delivering healthcare, medical assistance, emergency response, and workforce support services worldwide.

Jobdescription

Job Description

You'll use your clinical nursing experience to coordinate specialty care referrals that help military beneficiaries access timely, appropriate healthcare services. Working within a Referral Management Center (RMC), you'll review referrals, educate patients, collaborate with providers, and help ensure referrals move efficiently from initiation through completion while supporting continuity of care.

Schedule: Full-Time | Monday-Friday | Days (7:30 AM-4:30 PM) | Federal Holidays & Scheduled Down Days Off

Key Responsibilities

• Review, coordinate, and manage specialty care referrals from initiation through completion while ensuring compliance with TRICARE requirements, referral management business rules, and established timeliness standards.
• Assess referral completeness, verify patient eligibility and demographic information, coordinate with referring providers when additional clinical information is needed, and schedule specialty appointments within established access-to-care guidelines.
• Educate patients regarding referral processes, specialty appointments, required testing, procedures, and pre-appointment instructions while serving as a clinical resource for referral-related questions.
• Collaborate with providers, case managers, utilization management staff, specialty clinics, and network partners to facilitate appropriate referrals, resolve referral issues, and support continuity of care.
• Monitor referral activity, obtain and process specialty care documentation, maintain accurate referral records, generate referral-related reports, and help ensure referral documentation is returned to the patient's medical record within established timelines.
• Perform first-level clinical reviews of specialty referrals, identify patients who may benefit from additional care coordination, participate in quality improvement activities, and contribute to ongoing Referral Management Center operations.

Qualifications

Requirements

• Graduate of an accredited practical or vocational nursing program.
• Current, unrestricted Licensed Practical Nurse (LPN) license in good standing and current BLS certification through the American Heart Association or American Red Cross.
• 2+ years of broad-based clinical nursing experience in an inpatient or outpatient setting within the last three (3) years.
• Experience interpreting and applying medical necessity criteria or utilization review guidelines, such as InterQual or Milliman Ambulatory Care Guidelines.
• Working knowledge of referral management processes, electronic medical systems, Microsoft Office applications, customer service principles, and professional healthcare communication.

Preferred

• Experience supporting referral management, utilization management, case management, or care coordination within a military, government-supported, or integrated healthcare environment.
• Experience working with TRICARE, CHCS, AHLTA, HAIMS, RMS, DEERS, or similar healthcare information systems.

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