LPN CLINICAL SPECIALIST
August 31, 2026 Alabama, Mobile Full-time
CLINICAL SPECIALIST, LPN
Department: Medical
Reports to: Director of Case Management/Care Coordination
Supervises: N/A
Classification: Non-Exempt
JOB SUMMARY
The Clinical Specialist, LPN responds to incoming calls from internal and external customers to address requests, answer questions and inquiries, troubleshoot problems, provide information and education, and assist in resolving informal complaints regarding services.
The Clinical Specialist handles clinical calls from patients and customers and manages, coordinates, and directs inbound calls for Franklin care teams at multiple locations. Responsibilities include, but are not limited to, simple transfers, informational and educational calls, appointment scheduling, referral requests, medication refills, and medical inquiries.
The Clinical Specialist promptly answers, screens, and processes medical service requests and telephone inquiries with strict adherence to confidentiality requirements, established protocols, policies, and procedures. The Clinical Specialist works closely with the care team and immediately facilitates patient access to the appropriate care team member when needed. This position also facilitates care coordination and case management activities to support the care team as appropriate.
ESSENTIAL FUNCTIONS
- Handles outbound and inbound calls and emails from external and internal customers.
- Answers the telephone in a courteous, professional, and efficient manner. Obtains and records the caller's name, time of call, nature of business, and person called upon.
- Facilitates timely messages for the care team by accurately recording information in the EHR system and tasking information to the appropriate individual.
- Follows up on complicated customer calls when required.
- Completes call logs and call reports as necessary and updates information in the EHR/EPM.
- Obtains appropriate prior authorizations as necessary for medications, tests, referrals, and other services.
- Processes forms, orders, and applications requested by internal and external customers.
- Maintains confidentiality of patients' medical information and work materials as appropriate.
- Participates in the care team's quality improvement activities.
- Utilizes established clinical protocols, policies, and procedures to assist patients and external customers as appropriate.
- Properly documents treatments, medications, laboratory results, telephone messages, referrals, and other relevant information.
- Utilizes skilled listening techniques.
- Researches required information using accessible resources.
- Responds to Crisis/Red Flag calls and refers patients to appropriate care team staff. Follows through with the patient and care team staff until resolution.
- Participates in internal and external educational opportunities relevant to the customer service environment, including but not limited to care coordination and case management in-service education and training.
- Involves patients in activities to improve their health through patient engagement. Uses assessment skills and implements patient teaching, education, and self-management.
- Participates in appropriate training sessions and maintains CEUs as required by the State Nursing Licensure Board, if applicable.
- Utilizes the RTS system to verify patient insurance at each contact and updates insurance information in the EHR as changes are identified.
- Supports provider meaningful use efforts by collecting necessary information, including but not limited to the pharmacy utilized by the patient, email address, and other providers seen.
- Is cross-trained in other Call Center areas and may occasionally be required to work in other Call Center areas as necessary.
- Performs any other duties deemed necessary by the immediate supervisor and/or Director of Outreach/Care Coordination.
TELEPHONE ASSESSMENT AND EVALUATION
- Telephone assessment of symptoms and active problems must be performed by a licensed nurse (LPN or RN).
- In the event a licensed nurse is not available, the representative will immediately facilitate the patient's access to an appropriate member of the patient's care team.
ADDITIONAL RESPONSIBILITIES
- Identifies and escalates priority issues and reports them to the Manager.
- Routes inbound calls to the appropriate resources.
- Obtains and evaluates all relevant data to handle requests, complaints, and inquiries.
- Records details of requests, comments, inquiries, complaints, and actions taken.
- Participates in the organization's Quality Assurance Program.
- Demonstrates punctuality and good attendance at work.
- Serves as a technical resource in related computer applications.
- Demonstrates effective communication skills and the ability to work closely with others.
- Demonstrates good keyboard skills and professional telephone etiquette.
- Responds effectively and calmly in emergency situations.
- Maintains customer confidentiality.
- Demonstrates strong communication skills and basic computer knowledge.
- Demonstrates flexibility, initiative, and perseverance.
- Works effectively under pressure.
- Manages multiple responsibilities simultaneously.
The preceding examples are representative of the assignments performed by this position and are not intended to be all-inclusive.
CUSTOMER SATISFACTION REQUIREMENTS
Must provide the very best customer satisfaction to patients and co-workers at all times in a professional and courteous manner.
- Actively maintains a clean and safe environment with a professional and welcoming image.
- Actively protects customer confidentiality.
- Treats customers as welcome guests and provides a warm and sincere greeting.
- Consistently presents a professional appearance in dress and grooming in accordance with the dress code policy.
- Effectively and consistently demonstrates the values of the organization.
- Effectively involves customers in decisions that affect them.
- Follows through in a timely manner on commitments made to customers.
PERFORMANCE STANDARDS
Performance will be evaluated by the Director of Outreach/Care Coordination or designee annually using the Performance Evaluation Form, wherein an overall satisfactory rating is considered the minimum acceptable level of performance.
HEALTH AND SAFETY REQUIREMENTS
The health and safety requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- Must adhere to safety regulations, personnel policies, and procedures.
- Must receive Safety and Hazardous Communication training annually.
- Must maintain yearly health maintenance records by obtaining TB skin testing.
PRIVACY RULE COMPLIANCE REQUIREMENTS
- Adheres to Health Insurance Portability and Accountability Act (HIPAA Privacy Rule) policies and procedures.
- Must successfully complete Privacy Rule compliance training annually or as revisions are made to the policies and procedures.
- Must comply with Privacy Rule guidelines by protecting FPHC patients' medical privacy.
- Must appropriately maintain patient information in compliance with applicable standards.
- Must provide appropriate security of FPHC patient records.
PROTECTED HEALTH INFORMATION (PHI) ACCESS
RESTRICTED: For purposes of HIPAA Compliance, there are four workforce categories that define the level of access to PHI granted to the incumbent. This position is classified under Administrative Staff and is therefore granted Restricted access as defined according to the workforce member's specific job duties. Use and disclosure must be in accordance with applicable privacy policies and procedures.
QUALIFICATIONS
Education/Experience: Degree with at least two (2) years of experience in a health-related field. A licensed nursing degree is preferred; years of relevant experience may be substituted for the degree. Must be experienced in managing multiple duties, possess excellent communication skills, be extremely organized, capable of working in a stressful and fast-paced environment, and able to communicate effectively. Problem-solving skills are required. Ability to motivate and develop staff is necessary. Care coordination/case management experience is preferred.
Knowledge, Skills, and Abilities: Demonstrated knowledge and ability to operate telecommunication equipment efficiently and effectively. Ability to communicate clearly and effectively, both orally and in writing.
Certification, Licenses, and Registrations: LPN or higher.
PHYSICAL/MENTAL DEMANDS
Work is sedentary in nature. Requires working under stressful conditions.
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