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California State Licensed Utilization Management Nurse

Company: VirtualVocations
Location: Montgomery
Posted on: September 17, 2023

Job Description:

A company is looking for a Utilization Management Nurse (LVN) for a remote administrative position.
Key Responsibilities:

Performing daily clinical reviews while patients are in the hospital/SNF
Transferring members to an in-network hospital from an out-of-network ER/hospital

Required Qualifications:

Clear and active LVN CA State license
2+ years of telephonic utilization review/management experience from an acute care/inpatient/hospital stay setting (not payor side)
Experience with an MSO, Health Plan, or Delegated Risk arrangement
Understanding of regulatory requirements such as Medicare, Medi-Cal, and Commercial/DMHC
Computer savvy with Microsoft Office, strong skills in Excel; experience using Milliman or Interqual, EZ Cap 6 is a plus

Keywords: VirtualVocations, Montgomery , California State Licensed Utilization Management Nurse, Executive , Montgomery, Alabama

Click here to apply!

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