Medical Authorization Nurse (LVN)

We’re looking for a Medical Authorization Nurse (LVN) to support the prior authorization process, ensuring that medical service requests align with clinical guidelines and policies. In this role, you'll collaborate with providers, facilitate utilization management, and help patients access the care they need—all while keeping compliance and efficiency top of mind.

What You’ll Do:

• Evaluate medical service requests for clinical appropriateness and necessity.
• Process referrals, diagnostic tests, procedures, home health, and DME authorizations.
• Identify cases requiring Medical Director review and communicate decisions to providers.
• Ensure proper coding using ICD-10, CPT, and HCPCS standards.
• Maintain thorough and accurate documentation in the utilization management system.
• Support compliance initiatives, training efforts, and administrative tasks as needed.
  
  
  

All You Need

• Active California LVN license (unrestricted).
• At least 3 years of nursing experience, including 1 year in clinical review.
• 1 year of experience in utilization management or prior authorization.
• Strong proficiency in Microsoft Office and healthcare systems.
• CCM certification and experience in managed care settings (preferred)
  
  
  

Job Details:

• Department: UM - Prior Authorization
• Location: Onsite | Orange, CA
• Schedule: Monday – Friday, 8:00 AM – 5:00 PM
• Pay: $37.00/hr. – $45.00/hr. (DOE)
  
  
  

This is a great opportunity to collaborate with providers, facilitate utilization management, and help patients access the care they need. If you're interested, apply today!

EEO/AA Employer/Vet/Disabled.

The Know Your Rights poster is available here:

https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:

https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_ English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

ALL's WELL participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.

https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

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