Regulatory Compliance Nurse LPN/LVN (Remote in PST) Job-014672

Equity Staffing is searching for a Remote Regulatory Compliance Nurse LPN/LVN in PST. This position with a Fortune 500 organization. Our client serves more than 85 million people and has a reputation for bold ideas. If you enjoy working with energetic people in a collaborative environment, we want to speak with you!

*** Remote in PST ***

*** 9 Month Temporary Position ***

Specific Duties:

• In collaboration with the Manager of Delegation Compliance Clinical Services, manages delegation oversight and regulatory audits.
• Leverages knowledge of clinical services regulatory and delegation requirements to represent the company’s Clinical Services appropriately while managing delegation oversight audits
• Serves as a liaison between Health Plan delegated entities and Clinical Services Operational teams (Utilization Management and Case Management)
• Serves as a liaison between Delegation Compliance and cross-functional areas/departments across the organization
• Uses, protects, and discloses the company’s patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

Must have qualifications/experience:

• High School/GED or equivalent
• Graduation from an accredited Licensed Vocational/Practical Nurse program
• Current LVN/LPN license in State of Residence
• 3 years of clinical experience working as an LVN/LPN
• 2 years of care management, utilization review (prior authorization) or discharge planning experience
• Medical Office Experience
• Medical Terminology Knowledge
• Problem Solving Skills
• Experience working in a fast paced team environment
• Great Multitasker
• Positive Attitude
• Good Typing Skills
• Great Customer Service Skills
• Attention to Detail
• Strong Organizational Skills
• Effective communication skills both written and verbal
• Strong computer skills
• Proficient in Microsoft Office Suite of Tools.
• Critical thinking skills.
• Ability to work with others

Preferred Qualifications/Experience:

• Experience in an HMO or experience in a Managed Care setting
• A base knowledge of requirements for Medicare, Medi-Cal and Commercial lines of business
• Interview via video conferencing

REMOTE/ONSITE: Remote in PST

Shift Start/End Time: Monday-Friday, 8am-5pm PST

Equity Staffing Group is one of the fastest growing Native American owned staffing companies in the United States. We are a certified Minority Business Enterprise (MBE) by the National Minority Supplier Development Council (NMSDC) and the Rocky Mountain Minority Supplier Development Council (RMMSDC).

Equity Staffing Group is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Equity Staffing Group will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

We welcome you to learn more about our company by visiting www.equitystaffing.com.

Job Types: Contract, Temporary

Pay: $28.00 - $36.00 per hour

Standard shift:

• Day shift

Weekly schedule:

• 5x8
• Monday to Friday

Experience:

• Compliance management: 1 year (Required)
• Case management: 1 year (Preferred)
• Utilization management: 1 year (Preferred)
• Managed care: 1 year (Preferred)
• Discharge planning: 1 year (Preferred)
• Medicare: 1 year (Preferred)

License/Certification:

• LVN (Required)
• BLS Certification (Preferred)
• LPN (Required)

Work Location: In person

Salary : $28 - $36