Licensed Practical Nurse - Medical Management Jobs

Coordinates with healthcare providers and plan members to maximize member benefits while managing costs. Assesses medical necessity of patient admissions, surgical and diagnostic procedures, and other related services. Conducts pre-certification or authorization, and monitors compliance with established medical guidelines and policies. May assist members in appeals for denied services. Requires a high school diploma. Typically reports to a registered nurse or supervisor. Requires graduation from approved LPN educational program. Requires a state license to practice. Years of experience may be ... unspecified. Certification and/or licensing in the position's specialty is the main requirement. More
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