LPN CLINICAL SPECIALIST

About the role

The Clinical Specialist, LPN responds to incoming calls from internal and external customers to address requests, answer questions and inquiries, troubleshoot problems, provide information and education, and assist in resolving informal complaints regarding services. The Clinical Specialist handles clinical calls from patients and customers and manages, coordinates, and directs inbound calls for Franklin care teams at multiple locations.

Responsibilities

• Handles outbound and inbound calls and emails from external and internal customers
• Answers the telephone in a courteous, professional, and efficient manner; obtains and records the caller's name, time of call, nature of business, and person called upon
• Facilitates timely messages for the care team by accurately recording information in the EHR system and tasking information to the appropriate individual
• Follows up on complicated customer calls when required
• Completes call logs and call reports as necessary and updates information in the EHR/EPM
• Obtains appropriate prior authorizations as necessary for medications, tests, referrals, and other services
• Processes forms, orders, and applications requested by internal and external customers
• Maintains confidentiality of patients' medical information and work materials as appropriate
• Participates in the care team's quality improvement activities
• Utilizes established clinical protocols, policies, and procedures to assist patients and external customers as appropriate
• Properly documents treatments, medications, laboratory results, telephone messages, referrals, and other relevant information
• Utilizes skilled listening techniques
• Researches required information using accessible resources
• Responds to Crisis/Red Flag calls and refers patients to appropriate care team staff; follows through with the patient and care team staff until resolution
• Participates in internal and external educational opportunities relevant to the customer service environment, including but not limited to care coordination and case management in-service education and training
• Involves patients in activities to improve their health through patient engagement; uses assessment skills and implements patient teaching, education, and self-management
• Participates in appropriate training sessions and maintains CEUs as required by the State Nursing Licensure Board, if applicable
• Utilizes the RTS system to verify patient insurance at each contact and updates insurance information in the EHR as changes are identified
• Supports provider meaningful use efforts by collecting necessary information, including but not limited to the pharmacy utilized by the patient, email address, and other providers seen
• Is cross-trained in other Call Center areas and may occasionally be required to work in other Call Center areas as necessary
• Performs any other duties deemed necessary by the immediate supervisor and/or Director of Outreach/Care Coordination
• Telephone assessment of symptoms and active problems must be performed by a licensed nurse (LPN or RN); in the event a licensed nurse is not available, the representative will immediately facilitate the patient's access to an appropriate member of the patient's care team
• Identifies and escalates priority issues and reports them to the Manager
• Routes inbound calls to the appropriate resources
• Obtains and evaluates all relevant data to handle requests, complaints, and inquiries
• Records details of requests, comments, inquiries, complaints, and actions taken
• Participates in the organization's Quality Assurance Program
• Demonstrates punctuality and good attendance at work
• Serves as a technical resource in related computer applications
• Demonstrates effective communication skills and the ability to work closely with others
• Demonstrates good keyboard skills and professional telephone etiquette
• Responds effectively and calmly in emergency situations
• Maintains customer confidentiality
• Demonstrates strong communication skills and basic computer knowledge
• Demonstrates flexibility, initiative, and perseverance
• Works effectively under pressure
• Manages multiple responsibilities simultaneously

Qualifications

• Degree with at least two (2) years of experience in a health-related field
• Licensed nursing degree preferred; years of relevant experience may be substituted for the degree
• Care coordination/case management experience preferred
• LPN or higher licensure
• Must be experienced in managing multiple duties, possess excellent communication skills, be extremely organized, capable of working in a stressful and fast-paced environment, and able to communicate effectively
• Problem-solving skills required
• Ability to motivate and develop staff necessary

Skills

• Demonstrated knowledge and ability to operate telecommunication equipment efficiently and effectively
• Ability to communicate clearly and effectively, both orally and in writing
• Demonstrated good keyboard skills and professional telephone etiquette
• Strong communication skills and basic computer knowledge
• Flexibility, initiative, and perseverance
• Ability to work effectively under pressure
• Ability to manage multiple responsibilities simultaneously
• Ability to respond effectively and calmly in emergency situations

Pay

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