LPN CLINICAL SPECIALIST

Clinical Specialist, LPN

Job Summary:
The Clinical Specialist, LPN responds to incoming calls from internal and external customers, addressing requests, answering questions, troubleshooting issues, and providing education and support. This role manages, coordinates, and directs inbound clinical calls for Franklin Primary Health Center care teams across multiple locations. Responsibilities include appointment scheduling, referrals, medication refills, and medical inquiries. The Clinical Specialist ensures prompt, accurate handling of requests while maintaining strict confidentiality and adherence to established protocols. This position also supports care coordination and case management activities to facilitate patient access to care.

Essential Functions:

• Handles inbound and outbound calls and emails from internal and external customers.
• Answers calls in a professional, courteous, and efficient manner.
• Accurately documents caller information, including name, time, and nature of call.
• Facilitates timely communication with care teams by documenting and routing messages in the EHR system.
• Follows up on complex customer inquiries and issues.
• Completes call logs and updates reports in EHR/EPM systems.
• Obtains prior authorizations for medications, tests, and referrals as needed.
• Processes forms, orders, and applications for internal and external customers.
• Maintains strict confidentiality of patient information and materials.
• Participates in care team quality improvement initiatives.
• Utilizes clinical protocols, policies, and procedures to support patient care.
• Documents treatments, medications, lab results, phone messages, and referrals accurately.
• Demonstrates strong listening and problem-solving skills.
• Researches information using available resources.
• Responds to crisis or urgent calls and escalates to appropriate care team members.
• Participates in educational and training opportunities related to care coordination and customer service.
• Engages patients in health improvement activities through education and self-management support.
• Maintains required continuing education units (CEUs) as applicable.
• Verifies patient insurance using RTS and updates EHR records accordingly.
• Supports provider documentation and meaningful use initiatives.
• Cross-trains in other call center functions as needed.
• Performs other duties as assigned by leadership.

Telephone Assessment and Evaluation:

• Telephone assessment of symptoms and active problems must be performed by a licensed nurse (LPN or RN).
• If a licensed nurse is unavailable, the representative must immediately connect the patient with an appropriate care team member.

Additional Responsibilities:

• Identifies and escalates priority issues to management.
• Routes calls to appropriate departments or resources.
• Collects and evaluates information to address inquiries and complaints.
• Documents all interactions and actions taken.
• Participates in organizational quality assurance programs.
• Maintains punctuality and consistent attendance.
• Demonstrates proficiency with computer systems and applications.
• Exhibits strong communication and interpersonal skills.
• Maintains professionalism and effective telephone etiquette.
• Responds calmly and effectively in emergency situations.
• Handles multiple tasks and priorities simultaneously.

The above statements are representative of the position and are not intended to be all-inclusive.

Customer Satisfaction Requirements:

• Maintains a clean, safe, and welcoming environment.
• Protects customer confidentiality at all times.
• Provides a warm, professional, and courteous experience to all customers.
• Maintains a professional appearance in accordance with dress code policy.
• Demonstrates organizational values consistently.
• Involves customers in decisions affecting their care.
• Follows through on commitments in a timely manner.

Performance Standards:
Performance is evaluated annually by the Director of Outreach/Care Coordination or designee. A satisfactory rating is considered the minimum acceptable level of performance.

Health and Safety Requirements:

• Adheres to all safety regulations, policies, and procedures.
• Completes annual Safety and Hazardous Communication training.
• Maintains required health records, including annual TB testing.

Privacy Rule Compliance Requirements:

• Adheres to HIPAA Privacy Rule policies and procedures.
• Completes annual privacy training or as required.
• Protects patient medical information in compliance with regulations.
• Maintains patient records according to national standards.
• Ensures appropriate security of patient information.

Protected Health Information (PHI) Access:
This position is classified as Administrative Staff and is granted restricted access to PHI in accordance with job duties and privacy policies.

Qualifications:

Education and Experience:
Degree with a minimum of two (2) years of experience in a healthcare-related field required. Licensed nursing degree preferred; equivalent experience may be substituted. Experience in care coordination or case management preferred.

Knowledge, Skills, and Abilities:

• Proficiency in telecommunication systems and electronic health records.
• Strong written and verbal communication skills.
• Excellent organizational and multitasking abilities.
• Strong problem-solving and critical-thinking skills.
• Ability to work effectively in a fast-paced, high-pressure environment.

Certification, Licenses, and Registrations:

• Licensed Practical Nurse (LPN) or higher

Other Qualifications:

• English proficiency required; bilingual candidates preferred.

Physical and Mental Demands:

• Work is primarily sedentary.
• Requires the ability to work under stressful conditions.

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