- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Veterans Affairs, Veterans Health Administration (Ukiah, CA)
- …EDRP Coordinator for questions/assistance. Learn more Duties and responsibilities of the LVN /LPN include: Performs retrospective medical review of non-VA health ... Summary The Intermittent Licensed Vocational Nurse/Practical Nurse ( LVN /LPN) has a broad degree of practical nursing knowledge and skills. The LVN /LPN will care… more
- 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; Vocational… 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 ... could be the job for you! JOB SUMMARY: The primary purpose of the lead LPN/ LVN is to provide direct nursing care to the residents. ESSENTIAL FUNCTIONS: + Ensure the… more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the ... of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for physician … more
- 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 ... Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric...Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to… more
- Dignity Health (Woodland, CA)
- …of Participation requirements as measured by defined evaluation processes (ie UR review , Patient Care, IDT processes etc.) + Documents appropriate management of ... visit utilization and authorization status as measured by a designated...of RN. **Qualifications** **Minimum Requirements:** **Education and Experience:** + LVN Experience within the last 5 years. + 2… more
- UCLA Health (Los Angeles, CA)
- …patient records + Familiarity with the laws, rules, and regulations regarding utilization review and discharge planning of government programs such Medicare, ... care plans + Utilize evidence-based tools for risk stratification + Perform utilization reviews, including authorization reviews + Ensure delivery of concurrent and… more
- Molina Healthcare (Los Angeles, CA)
- …Licensed Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable ... Delegation Oversight Manager with additional duties of the team. We are looking for LVN 's with at least 4 years of UM experience, NCQA accreditation, and knowledge… more
- Molina Healthcare (San Jose, CA)
- …Licensed Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable ... state and federal regulations. **Required License, Certification, Association** Active, unrestricted State Licensed Vocational Nurse or Licensed Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse (RN) Program… more
- Evolent (Juneau, AK)
- …+ 1-3 years' experience in clinical Appeals Review or Utilization Management Review as an LPN or LVN is required. + Must maintain a courteous and ... appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies...set up the appeal, physicians and other clinicians who review the appeal, the claims department to review… more
- Tenet Healthcare (Detroit, MI)
- …to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and right to ... national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition Management… more
- Veterans Affairs, Veterans Health Administration (Clearlake, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... as vacancies become available.** Duties and responsibilities of the Telehealth LVN /LPN include: Performs Store and Forward (SFT) imaging, to include; Tele-Eye… more
- ManpowerGroup (Columbia, SC)
- …communicate with members and healthcare providers. **Key Responsibilities** ✔ **Medical Review & Utilization Management (80%)** + Perform medical reviews ... + Review interdepartmental requests for medical information to support utilization processes. + Conduct high-dollar forecasting and patient health summaries. +… more
- Veterans Affairs, Veterans Health Administration (Butler, PA)
- …are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants are ineligible to apply. ... in-services, completing mandatory annual training and unit-specific competencies and utilization of current nursing research. Compressed/Flexible: May be made… more
- ChenMed (St. Louis, MO)
- … and discharge planning. **KNOWLEDGE, SKILLS AND ABILITIES:** + Knowledge of Utilization Review (UR) and discharge planning + Strong interpersonal and ... ACN role may be performed by an RN or LPN/ LVN with each performing within their state specific licensure...experience required + A minimum of 1 year of utilization review and/or case management, home health,… more
- Banner Health (Phoenix, 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
- Banner Health (Scottsdale, 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
- Banner Health (Brush, CO)
- …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
- Banner Health (Phoenix, 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
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