- Kelsey-Seybold Clinic (Pearland, TX)
- …( LVN )** **Location: Pearland Administrative Office, Main Campus** **Department:** ** Utilization Management ** **Job Type: Full Time** **Salary Range: $59,108 ... **Responsibilities** The Utilization Review Specialist ( LVN ) is responsible for conducting medical reviews, benefit verification, and applying criteria to… 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 ... environment + Previous clinical experience + Experience drafting and issuing compliant adverse organization determinations + In-depth knowledge of health plan, DMHC, CMS, HIPPA, and NCQA requirements + Expertise in abstracting and interpreting medical… more
- Scripps Health (San Diego, CA)
- …preferred. **Job:** **Pt Care Technical* **Organization:** **Scripps Health Corp* **Title:** *Quality LVN - Utilization Review - Remote within San Diego County* ... to staff on quality standards and procedures *Required Qualifications:* * Current California LVN license * Three years recent clinical experience in a variety of… more
- CVS Health (Austin, TX)
- …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...driven timelines. Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- Matrix Providers (Jacksonville, FL)
- …TRICARE directives, coordinating with the local Medical Home Port (MHP) clinic, utilization and Referral Management policies, and obtains additional clinical ... Licensed Practical Nurse (LPN/ LVN ) -Naval Hospital Jacksonville, FL Location: Jacksonville, FL,...Consult, coordinate, and collaborate with MHP team members, referral management team members, specialty care clinics, outside care professionals,… more
- Sharp HealthCare (San Diego, CA)
- …Certification - Various-Employee provides certificate; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians; ... requirements for the position, and employer business practices. **_This is an LVN float pool position that services the following Sharp Rees-Stealy locations: San… more
- The Cigna Group (Harlingen, TX)
- …Nursing. * Three to Five (3-5) years recent experience in an acute-care environment, case- management or utilization management position (experience can be a ... provider practices * Identifies high-risk/high-cost patients for possible case management intervention. * Interfaces with providers of medical services and… more
- Molina Healthcare (Riverside, CA)
- …seeking a LVN (Licensed Vocational Nurse) with experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual ... 3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active,… more
- Sharp HealthCare (La Mesa, CA)
- …(AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** ... the position, and employer business practices. _This is a float pool LVN position that services the following Sharp Rees-Stealy locations: Rancho Bernardo, Scripps… more
- Banner Health (Susanville, CA)
- … management process. Reviews audit results and presents summary information for management utilization and review. 7. May coordinate the admission process ... full-time employee is one who works as an independent LVN , supporting our back office team for the family...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… more
- STG International (Milledgeville, GA)
- …our Georgia Ware Veterans Home. JOB SUMMARY: The primary purpose of the lead LPN/ LVN is to provide direct nursing care to the residents. ESSENTIAL FUNCTIONS: + ... and education for self-help as appropriate. + Provide pain management for residents in accordance with established pain ...a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse ( LVN ) is on duty 24 hours a day. +… more
- Prime Healthcare (Ontario, CA)
- …plan. #LI-AS1 Qualifications Required qualifications: + Knowledge in discharge planning/ utilization management /case management terminology and functions, ... education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/176259/case- management -discharge-planner- lvn /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management… more
- Hospice Of San Joaquin (Stockton, CA)
- …are the focus of everything we do. We are seeking a Dynamic skilled, self-motivated LVN Nurse - PM Shift who thrives in a fast-paced environment and to support our ... the Hospice of San Joaquin Compliance manual. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW: Ensures compliance with the program plan, assuring quality… more
- Cedars-Sinai (Culver City, CA)
- …or serves as liaison, for administrative support activities including facilities management , pharmacy, utilization management , quality management ... of standard operating policies and procedures in collaboration with senior management . 3. Oversees and maintains necessary staff certifications and licensing… more
- The Cigna Group (El Paso, TX)
- …quality of care is maintained. Provides clinical assessments, health education, and utilization management to customers. Performs community visits or telephonic ... reside in El Paso, Texas area.** **Experience:** .Current unrestricted LPN/ LVN or RN licensure in the state of Texas....or Two years (2) years recent experience in a case- management or utilization management position… more
- Amergis (Orange, CA)
- The LPN/ LVN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... referrals for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making for care… more
- ERP International (Camp Lejeune, NC)
- **Overview** ERP International is seeking full-time **Licensed Practical** **/Vocational Nurses (LPN/ LVN )** in support of the Pain Management Clinic at theNaval ... by DOD and TRICARE directives, coordinating with the local MHP clinic, utilization and Referral Management policies, and obtains additional clinical data… more
- Prime Healthcare (La Palma, CA)
- …Responsible for the coordination of the various activities of the Case Management Department including utilization management , social services and ... Education and Work Experience + Knowledge of Discharge Planning/ Utilization Management / Case Management ...listed below): + RN license upon hire preferred + LVN license upon hire preferred with 5 years of… more
- Emanate Health (Glendora, CA)
- …Two years recent acute clinical experience. Experience with discharge. Planning, utilization management and critical pathways preferred. Effective written, ... Excellent customer service skills required. **Minimum License Requirement:** Current California LVN License. BLS. Other certification in Case Management … more
- Molina Healthcare (NV)
- …not a compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in management / ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more