- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Review Specialist ( LVN ) is responsible for conducting medical reviews, benefit verification, and applying criteria ... care services requiring authorization prior to services being rendered for members. The Utilization Review Specialist ( LVN ) serves as a liaison in… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and… more
- 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
- STG International (Macon, GA)
- …War Veterans Home in Milledgeville, GA. JOB SUMMARY: The primary purpose of the LPN/ LVN is to provide direct nursing care to the residents. ESSENTIAL FUNCTIONS: + ... forms, reports, evaluations, studies, charting, etc., as necessary. + Periodically review the department's policies and procedures manuals, job descriptions, etc.,… more
- 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 +...up calls which may include primary care physician and specialist appointment scheduling + Nurse notifies PCP daily of… more
- The Cigna Group (Hattiesburg, MS)
- …skills + Typing and computer knowledge- able to type 35WPM + Knowledge of utilization review requirements and procedures + Knowledge of current health care ... up calls which may include primary care physician and specialist appointment scheduling + Collaborates with the attending physician...Ocean Springs. **Experience** : + Current Licensure as a LPN/ LVN or RN, in the state of residence in… more
- Elara Caring (Dallas, TX)
- …caregivers, referral sources, and physicians. + Participates in clinical record audits, utilization reviews, Peer Review or Quality Improvement programs, as ... Time, in the Right Place. **Job Description:** **Patient Care Specialist ** At Elara Caring, we care where you are...Nursing is required. + 2+ years' experience as an LPN/ LVN + Current Certified LPN/ LVN + Proficiency… more
- Abbott (Plano, TX)
- …required clinical information for authorizations. + Work with respective carrier's utilization review department to obtain appropriate authorizations. + Work ... insurance, Worker's Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review . + Experience in medical device or DME… more
- Banner Health (Sun City, AZ)
- …management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission process ... at other agencies - a field preceptor, an IT specialist , a dedicated scheduler, a nurse preceptor during orientation...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
- The Cigna Group (Harlingen, TX)
- …skills * Typing and computer knowledge- able to type 35WPM * Knowledge of utilization review requirements and procedures * Knowledge of current health care ... discharge follow up calls which may include primary care physician and specialist appointment scheduling * Collaborates with the attending physician to achieve… more