What are the responsibilities and job description for the Nurse Review LVN (Prior Authorization) position at The Judge Group?
Location: Orange, CA
Salary: $37.00 USD Hourly - $55.00 USD Hourly
Description: Judge Healthcare is currently seeking a Case Manager LVN (Prior Authorization) in Orange, CA!!
Job Details: 6 month contract (W2, Weekly Pay, Benefits/401K Available)
Location: *FULLY ON SITE* , Orange, CA
Hours: Monday-Friday 8am-5pm
Compensation: Competitive and based on experience
You will be responsible for providing case management intervention on behalf of members with short term, stable and predictable courses of illnesses. You would also be responsible for answering the medical appropriateness, quality and cost effectiveness of proposed hospital/medical/surgical services in accordance with established criteria.
Responsibilities
By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help.
Contact: jmaybrier@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
Salary: $37.00 USD Hourly - $55.00 USD Hourly
Description: Judge Healthcare is currently seeking a Case Manager LVN (Prior Authorization) in Orange, CA!!
Job Details: 6 month contract (W2, Weekly Pay, Benefits/401K Available)
Location: *FULLY ON SITE* , Orange, CA
Hours: Monday-Friday 8am-5pm
Compensation: Competitive and based on experience
You will be responsible for providing case management intervention on behalf of members with short term, stable and predictable courses of illnesses. You would also be responsible for answering the medical appropriateness, quality and cost effectiveness of proposed hospital/medical/surgical services in accordance with established criteria.
Responsibilities
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
- Reviews requests for medical appropriateness.
- Verifies and processes specialty referrals, diagnostic testing, outpatient procedures, home health care services and durable medical equipment and supplies via telephone or fax using established clinical protocols to determine medical necessity.
- Screens requests for the Medical Director’s review, gathers pertinent medical information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director’s decision and documents follow-ups in the utilization management system.
- HS Diploma required
- Current CA LVN licensed required.
- 3 years of nursing experience required, 1 year of which must be as a nurse reviewer
- 1 year concurrent review experience preferred.
- Bilingual is a plus!
By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help.
Contact: jmaybrier@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
Salary : $37 - $55
