2 Utilization Management LVN Jobs in Montebello, CA
SORT BY
N
N
Utilization Management LVN
$76k-102k (estimate)
Full Time
1 Week Ago
North American Staffing Group is Hiring an Utilization Management LVN Near Montebello, CA
Job Description
Job Description
Medica Talent Group is excited to share this Temp to Hire opportunity with you!
We are looking for experienced Utilization Management LVNs seeking a new exciting opportunity. Our client offers growth and an exciting workplace to join along with competitive salary rates, great benefits , and tuition reimbursement!
For immediate consideration, Please submit your resume to: bchairez@medicatg.com
We are looking for experienced Utilization Management LVNs seeking a new exciting opportunity. Our client offers growth and an exciting workplace to join along with competitive salary rates, great benefits , and tuition reimbursement!
For immediate consideration, Please submit your resume to: bchairez@medicatg.com
Pay: $36hr
Overview
The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization
requests from all lines of business using respective national/state, health plan, nationally
recognized guidelines. Responsible for reviewing proposed hospitalization, home care, and
inpatient/outpatient treatment plans for medical necessity
Overview
The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization
requests from all lines of business using respective national/state, health plan, nationally
recognized guidelines. Responsible for reviewing proposed hospitalization, home care, and
inpatient/outpatient treatment plans for medical necessity
Qualifications
1. Current valid License as a Licensed Vocational Nurse.
2. Minimum of 2 years of managed care experience
3. Demonstrated ability to work with automated systems, including electronic medical
records and MS Office products such as Word, Excel and Outlook.
4. Excellent customer service; ability to be an effective communicator
5. Knowledge of federal, state and other applicable standards for clinical practice for
assigned area(s) of responsibility.
Responsibilities
1. Responsible for the daily review and processing of referral authorizations in accordance to
turnaround time (TAT) standards set by ICE/Health Plan
2. Works collaboratively with Hospitalists, hospital partners, and care teams to provide
holistic patient care that is focused on high quality in a cost effective
3. Monitors ongoing services and their cost effectiveness; recommending changes to the
plan as needed using clinical evidence-based criteria – Milliman, Interqual, CMS, National
Recognized American Academy of Specific Specialty, Health Plan specific criteria.
4. Utilizes authorization matrix, ancillary rosters, DOFR, and/or delegation agreements to
drive decision-making
5. Maintains up to date knowledge of rules and regulations governing utilization
management processes;
6. Input data into the Medical Management system to ensure timeliness of referral
processing.
7. Verifies member benefits and eligibility upon receipt of the treatment authorization
request.
INDMED
Job Summary
JOB TYPE
Full Time
SALARY
$76k-102k (estimate)
POST DATE
06/15/2024
EXPIRATION DATE
06/28/2024
WEBSITE
nasg.com
HEADQUARTERS
BREA, CA
SIZE
1,000 - 3,000
FOUNDED
2000
TYPE
Private
CEO
FRED FLORES
REVENUE
$10M - $50M
INDUSTRY
Business Services
Related Companies
About North American Staffing Group
NASG is a recruitment agency that offers staff augmentation services for IT industry.
Show more
Similar Jobs
Popular Articles
Top 10 Things to Avoid Putting on a Job Application
Read Article
How to Describe Your Education in a Resume
Read Article
How to Write a Memorable Cover Letter in 5 Ways
Read Article
4 Personal Finance Tips to Make During Job Transition
Read Article
4 Best Camera Setups for Interview
Read Article
Keeping a Job Search Journal: 9 Types of Journaling You Can Do
Read Article
