Dohmen Life Science Services

  • Clinical Navigation Resource Coordinator

    Job Locations US-MO-Chesterfield
    Job ID
    2018-2028
    # of Openings
    1
    Category
    Administrative/Clerical
  • Overview

    OUR CULTURE:

    At DLSS, we are committed to keeping our clients for life, ensuring no conflict of interest exists, achieving continuous innovation, and focusing on continuous improvement.  Our behavior is guided by five simple values that define how we work and are the essence of what makes us successful:

     

    Caring: We are empathetic and respectful.  We ask “How can I help you?”

    Committed: We are dedicated and persistent.  We ask “How can I make it happen?”

    Creative: We are inventive and imaginative. We ask “How can I do it better?”

    Collaborative: We are cooperative and share our knowledge. We ask “How can we achieve success?”

    Courageous: We’re willing to risk failure over inaction. We ask “How can I challenge myself”

     

    THE POSITION:

    This position provides administrative, organizational and clerical support to the Clinical Navigation Department.  The most important function of this role is to facilitate and maintain the credentials/licensing files for all Nursing Network consultants and agencies and to collaborate with the Medical Necessity Appeals team to accomplish an efficient Medical Necessity Appeals process.

     

    critical responsibilities:

    • Ensure timely credentialing and re-credentialing of Nursing Network consultants and agencies.
    • Demonstrate good work ethic and pro-actively seek quality improvement activities.
    • Maintains patient and client confidentiality.

     

    essential duties and REsponsibilities:

    • Coordinate and monitor the review and analysis of the credentialing database within the Nursing Network and help facilitate the patient consented Medical Necessity Appeals process.
    • Identify and report issues that require additional investigation, validate discrepancies, and ensure appropriate follow up.
    • Assist in the coordination, submission and updates of patient consented medical necessity appeals.
    • Collaborate with Clinical Nurse Coordinators, as needed, to resolve any credentialing issues and the Medical Necessity Appeals team to resolve any appeals related issues.
    • Perform miscellaneous job-related duties as assigned.

     

    MINIMUM qualifications:

    The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.

    • High School Diploma or GED
    • 1 year of administrative experience, preferably in a health care or pharmacy setting
    • Excellent verbal, written, and proofreading skills
    • Ability to prioritize and manage multiple tasks
    • Self-directed; reliable; detail oriented
    • Working knowledge of Microsoft Word, Excel and Outlook
    • Superior customer service and typing skills 

    Preferred Qualifications

    • NA 

    PHYSICAL AND mENTAL dEMANDS:

    This is a largely sedentary role.  While performing the duties of this job, the employee is regularly required to talk, hear, type and engage in repetitive motion. 

     

    The employee frequently is required to walk; use hands to finger, handle or feel; and reach with hands and arms.  The employee is occasionally required to stand or grasp. The employee is intermittently required to stoop or crouch; push or pull; or kneel. 

     

    The employee must occasionally lift and/or move up to 10 pounds and intermittently lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

     

    This role requires mental alertness. The employee must regularly communicate both verbally and written; concentrate on tasks; and remember and observe details. The employee must frequently adjust to changes; handle stress and emotions; and think analytically.

     

    The mental and physical requirements described here are representative of those that must be met by an individual to successfully perform the essential functions of this position.

     

    Working ENVIRONMENT:

    This job operates in a professional office environment. This role routinely uses standard office equipment. The noise level in the work environment is usually moderate.  The employee is not substantially exposed to environmental conditions.

     

    The work environment characteristics described here are representative of those an individual encounters while performing the essential functions of this position.

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