• Utilization Review LVN

    Dignity Health (Bakersfield, CA)
    …remote with a clear and current CA LVN license.** **Position Summary:** The Utilization Review LVN uses clinical judgement in providing utilization ... position is remote with a clear and current CA LVN license.** The purpose of Dignity Health Management Services...- Preps case thoroughly concisely and clearly for physician review . Researches EMR criteria medical policy and past history… more
    Dignity Health (02/01/24)
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  • LVN - Utilization Management

    Kelsey-Seybold Clinic (Pearland, TX)
    **Responsibilities** The Utilization Review LVN nurse will perform documentation review for medical necessity and benefit correlation of requested ... admissions for HMO, PPO and POS products. The UR LVN nurse will serve as facilitator of communication with...payor and other customers. **Job Title: Licensed Vocational Nurse Utilization Review -** ** Utilization Management** **Location:… more
    Kelsey-Seybold Clinic (03/16/24)
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  • LVN Central Utilization

    Universal Health Services (Temecula, CA)
    …The Southwest Healthcare Regional office in Temecula, CA is seeking Two (2) Per Diem LVN Central Utilization Review Nurses who will be responsible for ... correct payer source for hospitalization and communication. + Ensures compliance of utilization review practices as required by payers, external regulatory… more
    Universal Health Services (04/13/24)
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  • Utilization Review Specialist…

    Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
    …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical records ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
    Bakersfield Behavioral Healthcare Hospital (04/21/24)
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  • Utilization Review LPN LVN

    Providence (Mission Hills, CA)
    …Degree in Healthcare related field. + 3 years' Experience in utilization management or case management. **Why Join Providence?** Our best-in-class benefits ... are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our… more
    Providence (03/14/24)
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  • RN Utilization Review FT Days

    Tenet Healthcare (Detroit, MI)
    …of care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN /LPN and/or Authorization Coordinator as needed. (5% daily, ... RN Utilization Review FT Days - 2305004256 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and… more
    Tenet Healthcare (04/17/24)
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  • Utilization Management Denial Review

    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 ... and guidelines in the issuance of adverse organization determinations. You will review for appropriate care and setting while working closely with denial… more
    UCLA Health (03/27/24)
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  • Licensed Practical Nurse (LPN)…

    The Arora Group (Bethesda, MD)
    …- Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/ LVN ) - Utilization Review in Bethesda, Maryland to provide care to ... be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/ LVN ) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties in… more
    The Arora Group (02/23/24)
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  • Case Manager ( LVN ) - Utilization

    Sharp HealthCare (San Diego, CA)
    …1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** **Shift ... and authorizes medical services that meet medical criteria. The review of care is region specific and consists of...SNF, medical clinic etc.) + California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric… more
    Sharp HealthCare (02/27/24)
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  • UM Resource Coord LVN - Utilization

    Sharp HealthCare (San Diego, CA)
    …1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** **Shift ... and authorizes medical services that meet medical criteria. The review of care is region specific and consists of...SNF, medical clinic, etc). + California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric… more
    Sharp HealthCare (03/02/24)
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  • Case Mgr

    Universal Health Services (San Antonio, TX)
    …Diploma with 5 or more years of experience in mental health field and utilization review . LICENSURE/CERTIFICATION: LVN , RN, LPC or LMSW preferred. ... gym, ropes course and more. POSITION PURPOSE : Provides ongoing and systematic utilization review , coordinates patient care to optimize outcomes; advocates for… more
    Universal Health Services (03/29/24)
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  • Licensed Practical Nurse (LPN/ LVN )

    The Arora Group (Jacksonville, FL)
    Licensed Practical Nurse (LPN/ LVN ) Nurse Currently recruiting a Licensed Practical Nurse (LPN/ LVN ) in Jacksonville, Florida, to provide care for active duty ... site of service shall be Pain Medicine Clinic. The Licensed Practical Nurse (LPN/ LVN ) may be assigned to other clinic locations within the primary assigned Military… more
    The Arora Group (04/16/24)
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  • UM Care Review Clinician IP LPN…

    Molina Healthcare (Bronx, NY)
    …are eligible for Medicaid and Medicare.** **We are looking for a LPN or LVN Care Review Clinician with Prior Authorization experience. Experience with ... (UM) is highly preferred. Additional experience with appeals, quality review , MLTC/LTC experience, and experience with data collection/reports.** **_Bilingual… more
    Molina Healthcare (04/10/24)
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  • LPN/ LVN - Nurse Navigator

    Universal Health Services (Laredo, TX)
    …to promote optimal health benefits and outcomes (both clinical and financial). The ACO LVN Navigator will provide onsite review at the local primary care ... enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The ACO LVN Navigator is a licensed clinical LVN who functions as a… more
    Universal Health Services (04/27/24)
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  • Licensed Practical Nurse/Licensed Vocational Nurse…

    STG International (Washoe County, NV)
    THIS IS FOR A FUTURE OPENING Licensed Practical Nurse/Licensed Vocational Nurse (LPN/ LVN ) JOB SUMMARY: The primary purpose of the lead LPN/ LVN is to provide ... forms, reports, evaluations, studies, charting, etc., as necessary. + Periodically review the department's policies and procedures manuals, job descriptions, etc.,… more
    STG International (04/12/24)
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  • LVN - Urology - SRS Frost Street - Days…

    Sharp HealthCare (San Diego, CA)
    …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... Certification - Various-Employee provides certificate; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians;… more
    Sharp HealthCare (04/14/24)
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  • LVN -Pediatrics After Hour-SRS Rancho…

    Sharp HealthCare (San Diego, CA)
    …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; IV… more
    Sharp HealthCare (03/15/24)
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  • UM Specialist ( LVN ) - SNF - Sharp…

    Sharp HealthCare (San Diego, CA)
    …Complies with contracted health plan requirements for documentation of concurrent SNF review and utilization management activities performed in a manner ... 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; Other **Hours**… more
    Sharp HealthCare (04/03/24)
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  • Licensed Practical/Vocational Nurse (LPN/…

    ERP International (San Diego, CA)
    …is seeking full-time **Licensed Practical / Vocational Nurses (LPN/ LVN )** supporting **Naval Medical Center San Diego, CA ... that of other individuals performing similar services. Participate in peer review and performance improvement activities. Practice aseptic techniques as necessary.… more
    ERP International (03/21/24)
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  • LPN/ LVN or RN Value Based Care Nurse-…

    The Cigna Group (Mobile, AL)
    …skills + Typing and computer knowledge- able to type 35WPM + Knowledge of utilization review requirements and procedures + Knowledge of current health care ... and metrics for customers and communicates to provider + Review STAR summary gap report (daily) by payor +...and written **Experience** : + Current Licensure as a LPN/ LVN or RN , in the state of residence… more
    The Cigna Group (03/26/24)
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