Part-Time LCC Clinician: Incident & Care Coordination

Liberty-Resources,-Inc; Philadelphia (Philadelphia County); On-site; USD 58,000 - 76,000; Part time

Job summary

Liberty Community Connections seeks an LCC Clinician in Philadelphia, PA. This part-time role pays $42.00–$55.00 hourly and reports to the Quality Manager. You’ll work with MCO Incident management and Service Coordinator teams to oversee participant Critical Incidents.

Work is 80% in the office and 20% travel; reliable transportation is required to attend field visits. The position involves reviewing treatment plans and ensuring medical necessity and CMS compliance.

Qualifications

• Current, unrestricted Pennsylvania RN license or Licensed Clinical Social Worker
• 2+ years of experience in managed care OR 5+ years nursing experience
• At least 3 years case management, concurrent review or utilization management experience
• Ability to interact productively with individuals and multidisciplinary teams with minimal guidance
• Possess planning, organizing, conflict resolution, negotiating, and essential interpersonal skills

Responsibilities

• Ensures timely review of Consumer Critical Incidents to determine if the appropriate measures are taken in accordance with CMS coverage guideline and State Regulatory requirements
• Reviews proposed home care, and inpatient / outpatient treatment plans for medical necessity and efficiency in accordance with CMS coverage guidelines
• Will work in collaboration with the MCO Incident management and Service Coordinator teams, both internal and external to determine medical and social appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
• Assist Service Coordinator teams with Complex cases, PCSP process where necessary and medication review
• Will follow the consumer until the Incident has reached conclusion
• Identify and refer all potential quality issues to the Quality Management Department, and suspected fraud and abuse cases to Compliance Department
• Other duties as assigned

Skills

Interpersonal skills

Effective communication

Organizational skills

Confidentiality

Problem solving

Conflict resolution

PC software

Education

PA RN license

Licensed Clinical Social Worker (LCSW)

Job description

Liberty Community Connections seeks an LCC Clinician in Philadelphia, PA. This part-time role pays $42.00–$55.00 hourly and reports to the Quality Manager. You’ll work with MCO Incident management and Service Coordinator teams to oversee participant Critical Incidents.

Work is 80% in the office and 20% travel; reliable transportation is required to attend field visits. The position involves reviewing treatment plans and ensuring medical necessity and CMS compliance.