- UCLA Health (Los Angeles, CA)
- …with: + Current CA LVN licensure required + Two or more years of utilization review/ utilization management experience in an HMO, MSO, IPA, or health plan ... environment + Previous clinical experience + Experience drafting and issuing compliant adverse organization determinations + In-depth knowledge of health plan, DMHC, CMS, HIPPA, and NCQA requirements + Expertise in abstracting and interpreting medical… more
- Sharp HealthCare (San Diego, CA)
- …**Shift Start Time** **Shift End Time** Other; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** **:** ... **Required Qualifications** + Other : Graduate of an accredited Licensed Vocational Nurse ( LVN ) program. + California Licensed Vocational Nurse ( LVN ) - CA Board… more
- Emanate Health (Covina, CA)
- …Education Requirement:** **Minimum Experience Requirement:** Minimum of three years of utilization management experience. Experience in quality- related job ... States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by… more
- Sharp HealthCare (San Diego, CA)
- …(AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; Vocational ... for the position, and employer business practices. **_T_** **_his is an LVN float pool position that services the following Sharp Rees-Stealy locations: San… more
- UCLA Health (Los Angeles, CA)
- …least three years of acute hospital experience required + Two or more years of utilization management , case management or discharge planning experience in an ... + Utilize evidence-based tools for risk stratification + Perform utilization reviews, including authorization reviews + Ensure delivery of...HMO environment required + Team leading or management experience + Systems planning and care … more
- STG International (Milledgeville, GA)
- STGi is seeking a LPN/ LVN to provide services at our Georgia War Veterans Home. GWVH will be opening a new unit that will be dedicated to the needs related to ... you! JOB SUMMARY: The primary purpose of the lead LPN/ LVN is to provide direct nursing care to the...and education for self-help as appropriate. + Provide pain management for residents in accordance with established pain … more
- Banner Health (Tucson, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or... license in state of practice, temporary LPN or LVN license in state of practice, or compact LPN… more
- Sharp HealthCare (San Diego, CA)
- …Certification) - Various-Employee provides certificate; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; ... designated patient population. **Required Qualifications** + California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians… more
- Dignity Health (Woodland, CA)
- …processes (ie UR review, Patient Care, IDT processes etc.) + Documents appropriate management of visit utilization and authorization status as measured by a ... of RN. **Qualifications** **Minimum Requirements:** **Education and Experience:** + LVN Experience within the last 5 years. + 2...5 years. + 2 years recent experience as a LVN in a Home Health or Hospice Agency. **Licensure:**… more
- Molina Healthcare (Columbus, OH)
- …RN, LVN , or bachelor's trained candidates with a strong background in Utilization Management . Additionally, the applicant should have proven experience as a ... the development, implementation, and delivery of training curriculum for Utilization Management , Case Management , and...public health, social work, or health related field. **OR** LVN /LPN with an additional 4 years of related experience… more
- Tenet Healthcare (Detroit, MI)
- …Mgt. Leaders relating to Case Management scope of services, including utilization management , transition management promoting appropriate length of stay, ... and safe and timely patient throughput. Will integrate national standards for utilization management supporting medical necessity and denials prevention. … more
- Prime Healthcare (Chino, CA)
- …EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/205766/discharge-planner utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityChino Valley Medical Center… more
- Dignity Health (Rancho Cordova, CA)
- …to collaborate with members of NSSA Regional Health Services Research (HSR), Utilization Management , Quality Management and various other departments, ... with quality assurance/improvement is desirable, preferably as an RN, LVN , Pharmacist, Radiology Technologist, Rehabilitation Therapist, Respiratory Therapist, Laboratory… more
- Evolent (Columbus, OH)
- …**What You Bring:** + 1-3 years' experience in clinical Appeals Review or Utilization Management Review as an LPN or LVN is required. + Must maintain a ... on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies and procedures while… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …The primary purpose of the Licensed Practical/License Vocational Nurse (LPN/ LVN ) 6 is to perform assigned duties in a manner ... through the continuum of care, patient and family education, patient self- management and supporting factors that impact customer satisfaction. Duties of the… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition ... q) and other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES : Utilization Management : Balances clinical and financial requirements and resources… more
- ManpowerGroup (Columbia, SC)
- ** Utilization Management Nurse / Social Worker (Contract Position)** **Location:** Remote (Must Train Onsite for 1-2 Weeks) - Must Reside Within 3 Hours of ... 5:00 PM **Interview Format:** Microsoft Teams **Job Overview** We are seeking a ** Utilization Management Nurse or Licensed Social Worker** to perform medical… more
- ChenMed (St. Louis, MO)
- …years' clinical work experience required + A minimum of 1 year of utilization review and/or case management , home health, discharge planning experience required ... ACN role may be performed by an RN or LPN/ LVN with each performing within their state specific licensure...by either the RN or LPN include: + Conducts utilization view for appropriate utilization of services… more
- Banner Health (Greeley, CO)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... available for caregiver respite as well as complex symptom management . The Banner Hospice Team can provide comfort to...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
- Banner Health (Tucson, AZ)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or... license in state of practice, temporary LPN or LVN license in state of practice, or compact LPN… more