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Home Care LPN

Provides prescribed medical treatment and personal care services to ill, injured, convalescent, and disabled persons in home care e settings. Cares for a broad range of patients and provides preventative and rehabilitative nursing care under supervision of a Registered Nurse.: Under supervision of a Registered Nurse, delivers daily routine nursing care and services to patients. Assists in the implementation of a nursing care plan for patients in their home to help patients deal with their illness. Participates in the implementation of preventative and rehabilitative nursing procedures. Dresses wounds, gives enemas, douches, alcohol rubs, and massages. Applies compresses, ice bags, and hot water bottles. Observes patients and reports adverse reactions to medication or treatment to medical personnel in charge. Records patient vital signs and administers specified medication, orally or by injection, and notes time and amount on patients' charts. Assembles and uses such equipment as catheters, tracheotomy tubes, and oxygen suppliers. Collects samples, such as urine, blood, and sputum, from patients for testing and performs routine laboratory tests on samples. Sterilizes equipment and supplies, using germicides, sterilizer, or autoclave. Prepares or examines food trays for prescribed diet and feeds patients. Records food and fluid intake and output. Bathes, dresses, and assists patient in walking and turning. Cleans rooms, makes beds, and answers patient’s calls. Washes and dresses bodies of deceased persons. Serves as a liaison between the client and the private duty staff, and assesses the client's condition and the home environment. Provides health care instruction to patient and family members. Provides instruction to patients and their families on health care. Treats common ailments and dresses wounds. Observes and reports unusual or abnormal symptoms so that appropriate modifications may be made in the health care plan. This position typically requires graduation from an accredited LPN course and current state licensure with previous home care nursing experience. May administer prescribed medicines or start intravenous fluids.

LPN

Provides prescribed medical treatment and personal care services to ill, injured, convalescent, and disabled patients in such settings as hospitals, clinics, private homes, schools, sanitariums, and similar institutions. Takes and records patients' vital signs. Dresses wounds, gives enemas, douches, alcohol rubs, and massages. Applies compresses, ice bags, and hot water bottles. Observes patients and reports adverse reactions to medication or treatment to medical personnel in charge. Administers specified medication, orally or by subcutaneous or intermuscular injection, and notes time and amount on patients' charts. Requires an LPN or LVN license.: Assembles and uses such equipment as catheters, tracheotomy tubes, and oxygen suppliers. Collects samples, such as urine, blood, and sputum, from patients for testing and performs routine laboratory tests on samples. Sterilizes equipment and supplies, using germicides, sterilizer, or autoclave. Prepares or examines food trays for prescribed diet and feeds patients. Records food and fluid intake and output. Bathes, dresses, and assists patients in walking and turning. Cleans rooms, makes beds, and answers patients' calls. Washes and dresses bodies of deceased patients. In home care environment, serves as a liaison between the client and the private duty staff, and assesses the client's condition and the home environment. Provides health care instruction to patient and family members. May provide medical treatment and personal care to patients in private home settings. May assist in delivery, care, and feeding of infants. May inventory and requisition supplies.

Banking Loan Review Analyst

Evaluates quality of commercial loans and assigns risk rating indicating borrower's financial strength and probability of loan repayment. Selects loans to evaluate for credit risk according to factors, such as geographical location, and type and amount of loan. : Records data on worksheet, such as purpose of loan, balance, collateral, and repayment terms. Verifies value of collateral by calling appraisers and auction houses for current value of machinery and equipment. Calls real estate appraiser for new real estate appraisal. Evaluates information to determine whether lending officers have stayed within guidelines of lending authority, if loan is in compliance with banking regulations, and if required documents have been obtained. Identifies problem loans and describes deficiencies. Writes summary of analysis and reasons for assigning adverse risk rating. May act as senior analyst and coordinate data collection and evaluations of credit quality of commercial loans, and present loan review information and report to management.

Clerk Insurance Review

Performs a wide variety of duties ensuring the accuracy and completeness of insurance policies and applications. Work may exist at organizations providing insurance or at organizations who are recipients of insurance payments. Reviews insurance applications to ensure that all questions have been answered. Assists in identifying problems and ensures that the insurance information is accurate. Verifies insurance policy benefit information. Ensures insurance information and appropriate referrals have been completely and accurately obtained. Identifies special policy clauses or pre-existing conditions and verifies effective date of policies.: Verifies insurance policy benefits for new and returning patients with carriers and employers. Ensures all insurance information has been completely and accurately obtained. Documents all pertinent insurance information. Obtains authorization/pre-certification prior to the patient's visit or scheduled admission, or immediately following admission. Documents information given or received to support actions taken on insurance charges or referral issues. Educates patients and families on insurance issues. Communicates patient's fiscal responsibility in a professional manner. Notifies appropriate work units of patient's insurance coverage, authorizations, or status. Identifies all patients without third party financial benefits and directs them for financial counseling according to policies and procedures. Receives and reviews contracts to understand the contract provisions. Interprets managed care contracts for insurance coverage. Provides support to revenue cycle work units and other work units as assigned. May correspond with sales personnel to inform them of status of application being processed, and to encourage prompt delivery of policies to policyholders. May collect initial premiums and issue receipts. May compile periodic reports on new business for management. Performs other duties as assigned.

RN Field Case Manager

Provides ongoing evaluation and nursing case management services, meeting with clients in their homes, work-sites, or physician's or therapist's office. Assesses, evaluates, and analyzes injured workers’ medical and/or vocational status, and develops, coordinates, and implements a viable, realistic service plan. Monitors the progress of the injured/disabled individuals and reports results back to the employer and insurance carrier.: Develops a plan of care for patients from admission to discharge. Monitors individuals’ progress toward desired outcomes through assessments and evaluations. Communicates both in-person and by phone with client, medical providers, attorneys, employers, employees, insurance carriers, etc. Develops and administers education and prevention programs. Develops guidelines for working with patients, healthcare management companies, insurance companies, or other third party payers to determine quality, cost-effective care. Applies all special instructions required by individual insurance carriers and referral sources. Applies all laws and regulations that apply to the provision of rehabilitation services. Testifies when called upon to do so, to substantiate any casework or reports that may be seen as relevant to hearing involving client. Evaluates outcome of patient care. Prepares reports and other required paperwork as documentation of all casework activities. May arrange referrals, consultations, therapeutic services, and confers with other specialists on course of care and treatment.

Call Center Nurse RN

Provides telephone triage to member of the health plan. Advises and instructs callers on proper health care after assessing the urgency of symptoms or complaints.: Answers telephone inquiries, assesses symptoms and provides assistance to members of the health plan in accordance with established policies, procedures and protocols. Provides clinical nursing evaluation and assessment and instructs callers to seek appropriate medical care. Notifies physician on call with pertinent medical information or if consultation is deemed necessary by nurse. Provides nursing referral to appropriate and available resources, including affiliated services, affiliated medical practice or community resource. Enters data into a computerized database and forwards facsimiles to appropriate health providers. Consults and facilitates after hours communication with physicians, nurses, hospital staff and outside agencies. Communicates with pharmacies and providers to refill medications or to clarify prescriptions. Typically requires graduation from an accredited School of Nursing as a Registered Nurse with two years of hospital or public health nursing experience. May provide health insurance eligibility, pharmacy benefits, provider information, and other information to callers.

Medical Claims Review Nurse

Resolves, audits, and processes claims for clinically related issues to ensure accuracy of claims payment, supporting the Claims Administration Department. Maintains contact with community hospitals and providers, reviewing, processing, and auditing claims for payment and appropriateness of charges and pursues adjustments as warranted. Typically requires licensure as a Registered Nurse and at least one year of experience in utilization review or a managed care setting.: Screens, audits, and processes claims of specific criteria for appropriate payment. Establishes effective ongoing relationships with community hospitals and providers. Participates in educational, provider relations, and contracting meetings with providers to address medical claims payment issues. Visits the providers as necessary to compare billed charges to the medical record. Provides support to the Accounting Department in determining financial liability for out-of-plan medical services. Performs special projects, reconciliations, research, and analysis relating to the utilization and cost of medical services. Works closely with various departments to coordinate the flow of information involving payment of medical bills and analyses of financial liability. Ensures compliance with contractual obligations on claims payments. Documents findings and writes follow-up reports. Recommends and implements innovative strategies to retain members, contain medical costs, and improve efficiency.

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