Part-Time LCC Clinician: Incident & Care Coordination

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

Job summary

Liberty Community Connections in Philadelphia, PA is seeking an LCC Clinician to provide oversight of Consumer Critical Incidents in collaboration with MCO Incident management and Service Coordinator teams.

The role requires PA RN license or Licensed Clinical Social Worker, 2+ years in managed care (or 5+ years nursing), and 3+ years in case management. 80% office work with 20% travel; reliable transportation is needed to perform field duties. This position reports to the Quality Manager.

Qualifications

• Current, unrestricted PA 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.

Responsibilities

• Ensures timely review of Consumer Critical Incidents to determine appropriate CMS and regulatory actions.
• Reviews home care and inpatient/outpatient treatment plans for medical necessity and efficiency.
• Collaborates with MCO Incident management and Service Coordinator teams to determine medical and social appropriateness of inpatient and outpatient services.
• Assists with Complex cases and PCSP processes, and medication review.
• Follows consumer until incident concludes.
• Identifies quality issues and refers fraud/abuse to Compliance.
• Other duties as assigned.

Skills

Interpersonal skills

Communication

Organizational skills

Confidentiality

Problem solving

Conflict resolution

Education

Registered Nurse license (PA)

Licensed Clinical Social Worker

Job description

Liberty Community Connections in Philadelphia, PA is seeking an LCC Clinician to provide oversight of Consumer Critical Incidents in collaboration with MCO Incident management and Service Coordinator teams.

The role requires PA RN license or Licensed Clinical Social Worker, 2+ years in managed care (or 5+ years nursing), and 3+ years in case management. 80% office work with 20% travel; reliable transportation is needed to perform field duties. This position reports to the Quality Manager.