LVN, Lead Medication Referral Nurse - Full Time - Hourly - 100% Remote

Even during the COVID-19 pandemic, Desert Oasis Healthcare (DOHC) continued to receive recognition in 2020 for its company culture, as rated by its employees, and for service excellence, as rated by the local community. Not only was DOHC designated a Great Place to Work for the third consecutive year in 2020 but it also ranked #27 on the nationwide Fortune Best Workplaces in Health Care and Biopharma 2020 list. In addition, local readers voted DOHC Immediate Care Clinics as “Best of Desert 2020” in the Urgent Care category for its four locations in Palm Springs, Palm Desert, Indio, and Yucca Valley.

The lead Medication Referral Nurse, Utilization Management & Quality Monitoring Specialist is responsible for assisting with the oversight of daily operations and providing training and support to Medication Referral Coordinators. This role will provide high level, complex referral support and coordination to the manager; will serve as a liaison between the Referral Department, the requesting providers, and the Medication Referral team. Will serve as a subject matter expert to staff, assist with providing clinical staff development, and assist with health plan audits and quality improvement reports as necessary..

Facilitate open communication during team meetings and model collaborative problem-solving. Provide guidance and serve as a resource to Referral Coordinators. Assist with coverage and training as needed to support the daily operations of the departments. Support leadership by guiding referral staff in daily operations, coordinating staffing coverage within assigned areas, and offering input for timely and accurate performance reviews. Act as the primary resource for infusion/injection related questions pertaining to medication referral process, contracts, and benefits provider/member questions. Assist in the development of education material and training of all new employees. Participate in continuous quality improvement activities and audit evaluations. Assist in tracking, prioritizing, and responding to daily departmental requests to ensure timely resolution of UM/health plan audits. Assists management with the development of policy and procedures as required. Serve as a liaison with other departments to troubleshoot and resolve referral issues, escalating complex matters to management as needed. Support management by tracking referral turnaround times and accuracy by providing oversight of daily workflow to minimize processing errors in accordance with all regulations and protocols. Support leadership in maintaining a positive work environment by assisting with employee concerns, facilitating resolution of minor conflicts, and collaborating with management to address conflict resolution and referral-related issues. Perform other duties assigned. Be knowledgeable about your job so that you can serve others effectively Be accountable for your work Demonstrate appropriate body language and tone of voice