- 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
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Review Specialist ( LVN ) is responsible for conducting medical reviews, benefit verification, and applying criteria to ... services requiring authorization prior to services being rendered for members. The Utilization Review Specialist ( LVN ) serves as a liaison in reviewing… more
- 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
- 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
- Actalent (Sacramento, CA)
- LVN Outpatient Utilization Review - River City Medical Group Shift- Monday-Friday day shift Description: The Clinical Case Manager coordinates all ... decisions. Assists Medical Director with CCS appeals. Qualifications: + CA LVN License + At least 1 year of LVN experiences in a SNF or acute care setting About… more
- 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
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and the ... review depending on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN will facilitate, coordinate, and approve… more
- 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
- 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
- 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 Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve… more
- 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
- 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
- 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
- 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
- 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
- Robert Half Office Team (Los Angeles, CA)
- Description We are seeking a UM Review Nurse to ensure the quality and cost-efficiency of medical care by applying clinical knowledge and implementing policies and ... coordinate and approve medical referrals that meet specific criteria as a Utilization Management Nurse Specialist RN * Ensure timely and exact referral… more
- 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
- 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
- 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 (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