Clinical - LTSS Care Navigator

Immediate need for a talented Clinical - LTSS Care Navigator. This is a 06+months contract opportunity with long-term potential and is located in San Antonio, TX(Remote). Please review the job description below and contact me ASAP if you are interested.
 
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.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy 

.

#prof J2W:CB3