- Scripps Health (San Diego, CA)
- …**Pt Care Technical* **Organization:** **Scripps Health Corp* **Title:** * LVN - Utilization Review - Remote within San Diego County* **Location:** ... 10 years *As a Licensed Vocational Nurse, you will be:* * Responsible for review and management of assigned cases for members enrolled to Scripps Clinic Health Plan… more
- Molina Healthcare (Riverside, CA)
- …seeking a LVN (Licensed Vocational Nurse) with experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual ... to work some weekends and holidays. This is a remote position and you may work from home. Please...of an accredited Registered Nurse (RN), Licensed Vocational Nurse ( LVN ) or Licensed Practical Nurse (LPN) Program OR a… more
- Elevance Health (Tampa, FL)
- **Licensed Utilization Review II** **Location** : KS, FL. and VA. This is a remote position The ideal candidate will live within 50 miles Elevance Health ... Monday through Friday,10:30 - 7:00 Eastern time** The **Licensed Utilization Review II** responsible for working primarily...Current active unrestricted license or certification as a LPN, LVN , or RN to practice as a health professional… more
- Molina Healthcare (New York, NY)
- …performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... is highly preferred.** **_Further details to be discussed during our interview process._** ** Remote position in New York** **Work hours: Monday - Friday 8:00am -… more
- Molina Healthcare (Seattle, WA)
- …with the adult behavioral health system in Washington State and** ** Utilization Management experience is highly preferred.** **_Further details to be discussed ... during our interview process._** ** Remote position** **Work schedule M-F 8:30 AM to 5:00...and update authorizations + Utilize advanced clinical skills to review Care Assessments and available collateral information against criteria… more
- Integra Partners (Troy, MI)
- …do whatever it takes to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations ... & Development team as an Operations UM Training Specialist, specializing in Utilization Management (UM) processes. The ideal candidate will have a strong nursing… more
- US Tech Solutions (Columbia, SC)
- …PREFERRED/NICE TO HAVE skill sets/qualities: I would love to have someone with prior insurance/ utilization review experience, but I know that is not very common. ... equipment to be prepared. + The position is fully remote after that. + Please list out the top...any of the following in support of medical claims review and utilization review practices:… more
- Veterans Affairs, Veterans Health Administration (Santa Rosa, CA)
- …the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities Duties and responsibilities Incumbent ... performs retrospective medical review of non-VA health care records to determine medical...involving others in improving care. Identifies and assesses resource utilization and safety issues, taking appropriate action. Acquires knowledge… more
- ManpowerGroup (Columbia, SC)
- …of medical claims review processes, medical necessity guidelines, and utilization review practices. + Proficiency in medical terminology, coding procedures, ... **Job Title: Medical Claims Reviewer** **Pay Rate:23/Hr ( REMOTE opportunity after training)** **Duration:3+ Months on W2**...services. + Ensure thorough documentation of each determination for utilization or claims review . + Review… more
- Veterans Affairs, Veterans Health Administration (Chesapeake, VA)
- …and referrals. Completes assignments in a timely manner with constructive utilization of remining time. Initiates, administer, assess, monitor, and report IV ... Six months of qualifying experience as an LPN or LVN ; or Graduation from an approved school (which may...practices or procedures may be subject to closer higher-level review . GS-6 Completion of at least one (1) year… more
- Centene Corporation (Olympia, WA)
- …nursing or case management experience. Managed care or utilization review experience preferred. **License/Certification:** LPN, LVN , or RN license. Pay ... as the liaison for all statewide appeals, fair hearings, review organizations, and other external type appeals. Responsible for...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Guardian Life (Bethlehem, PA)
- …individual may also be required to help with coordinating and overseeing vendor utilization and assist in determining overall function as needed to facilitate timely ... claim decisions. You will + Review information in file, obtain medical information needed and/or...needs of our customers. You have + LPN / LVN from an accredited school of Nursing with a… more