[Remote] LPN Clinical Research Coordinator

Note: The job is a remote job and is open to candidates in USA. Arkansas Blue Cross and Blue Shield is seeking an LPN Clinical Research Coordinator to organize, analyze, research, and manage complex programs and medical data. The role requires collaboration with various internal functional areas and adherence to compliance standards while ensuring patient safety and care quality.ResponsibilitiesCommunication: Serves as a liaison facilitating a collaborate process between multiple internal functional areas, clinical leadership, primary physicians, patients and Medical Director to assist with escalated cases that requires input from multiple areas with the enterprise, providers, facilities and vendorsCompliance: Practices nursing within the scope of licensure and adheres to policies, procedures, regulations, URAC standards and individual state regulations; making decisions based on facts and evidence to ensure compliance, appropriate level of care, and patient safetyData Analysis: Integrates data from multiple data sources or functional areas, ensures data accuracy and integrity, and updates data as needed to develop models to be used for decision making and initiativesKnowledge: Remain current with up-to-date medical and surgical procedures, products, healthcare services and drugs, general trends in health care delivery; and enterprise procedures, policies and contractsOther duties as assignedParticipant: Serves on various committees and project teams related to policy changes, system enhancements, process improvement initiatives, etcProcess Improvement: Monitors and evaluates data and processes to ensure accuracy and identify changes to increase efficiency and effectivenessResearcher: Serves as a resource to Medical Director(s) and Care Management team providing analysis, reporting and research on medical conditions, medical terminology, medications, lab work, medical records, healthcare processes, coverage policies, plan guidelines, and/or health/wellnessSkillsHigh school diploma or equivalent requiredLicensed Practical Nurse (LPN) with current active state license in the state(s) where job duties are performed requiredMinimum four (4) years' clinical nursing experience, to include a broad background in various facets of nursingKnowledge of HCPCS/CPT/Revenue codes and general coding principlesKnowledge of claims processing rules/logicKnowledge of Health Plan operations, regulatory agencies and State/Federal regulations related to health careMinimum two (2) years' utilization review, medical policy, and/or case management experience requiredExcellent Oral & Written CommunicationDetail-OrientedStrong analytical, critical thinking, organizational and time management skillsProficiency using basic computer skills in Microsoft Office such as Word, Excel, Outlook, and PowerPoint, including the ability to navigate multiple systems and keyboardingAbility to make sound judgments and decisions based on facts and guidelinesAbility to build collaborative relationshipsAbility to work independently with little supervisionAbility to interpret complex documentationPrevious experience in appeals and/or grievances process preferredCompany OverviewArkansas Blue Cross and Blue Shield provides reliable insurance plans to Arkansans while being a valuable community partner. It was founded in 1948, and is headquartered in Little Rock, Arkansas, USA, with a workforce of 1001-5000 employees. Its website is http://www.arkansasbluecross.com.