- 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 ... using clinical judgment and refer to Medical Directors for review depending on case findings. Functions & Job Responsibilities...on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN … 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
- Robert Half Office Team (Los Angeles, CA)
- …Facilitate, coordinate and approve medical referrals that meet specific criteria as a Utilization Management Nurse Specialist RN * Ensure timely and exact ... Description We are seeking a UM Review Nurse to ensure the quality and cost-efficiency...deadlines outlined by the latest department policy. Requirements Active LVN license Robert Half is the world's first and… 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
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review /MediCal Specialist will develop and maintain a full ... of care from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review /MediCal Specialist will manage the program to… 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
- 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 (Mesa, 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
- Robert Half Management Resources (Monterey Park, CA)
- …auditors, and reviewing audit submissions. Responsibilities: . The Compliance Specialist RN will facilitate, coordinate, and approve medically necessary referrals ... . May performs telephonic and/or on-site admission and concurrent review , and collaborates with onsite staff, physicians, providers, member/family interaction… 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