- 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
- Matrix Providers (Jacksonville, FL)
- Licensed Practical Nurse (LPN/ LVN ) -Naval Hospital Jacksonville, FL Location: Jacksonville, FL, United States Healthcare Provider Type : Nursing START YOUR ... Come home to Matrix. Matrix Providers is hiring a Licensed Practical Nurse (LPN/ LVN ) to join our team of talented professionals who provide health care services… 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; Vocational… more
- Sharp HealthCare (La Mesa, 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
- 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: + ... forms, reports, evaluations, studies, charting, etc., as necessary. + Periodically review the department's policies and procedures manuals, job descriptions, etc.,… more
- Hospice Of San Joaquin (Stockton, CA)
- …about the Hospice philosophy and Hospice's services. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW : Ensures compliance with the program plan, assuring ... of everything we do. We seek a Dynamic, self-motivated LVN - PM Float who thrives in a fast-paced... of resources. + Participates in Quality Assessment/Improvement and Utilization Review activities as requested by administration.… more
- CVS Health (Austin, TX)
- …outreach calls to physician offices. -Conducts prospective, concurrent, and/or retrospective review of cases using health plan/employer agreed upon -Documentation of ... CVS\Caremark following agreed upon approval & denial management processes. -Generate, review , and validate reporting related of program results -Participate in… more
- CVS Health (Chicago, IL)
- …advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and ... timelines. + Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department ...LPN in IL + 2+ years of experience as LPN/ LVN + Must reside in Chicago IL or surrounding… 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 as… more
- Sutter Health (Concord, CA)
- …of practice Fiscal Responsibility (includes productivity, HHRG rating, supply management, utilization review ) * Demonstrates ability to prioritize individual ... referral sources and community agencies * Demonstrates knowledge and appropriate utilization of internal, community resources to meet patient needs * Demonstrates… more
- MTC (Raymondville, TX)
- …nursing director with the exception of routine duties assigned to the nurse ( LVN ) in compliance with MTC Medical and customer directives. **Essential Functions:** + ... utilize appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain absolute… more
- Elara Caring (Cleburne, TX)
- …+ Assists staff in maintaining current and accurate medical records and utilization review . + Assists clinical supervisor with non-clinical phone inquiries. ... + Notifies supervisor of any problems requiring administrative attention and intervention. + Processes and distributes in and out daily mail for the department, collects and maintains inventory, and cleans equipment. + Implements all available actions to… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …mental health and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: $31.00-$49.24 PER HOUR REPORTS ... TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as...license as an LCSW, ASW, MFT, LMFT, RN, LPT, LVN or LPC + Preferred; Master's degree in Social… more
- Prime Healthcare (Garden City, MI)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/189057/discharge-planner utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Education and Work Experience Required qualifications1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both… more
- Elevance Health (Tampa, FL)
- …America's 1st Choice operates as a wholly-owned subsidiary of Elevance Health. **Licensed Utilization Review Sr.** **Office Location:** This is a virtual role, ... sites used for collaboration, community, and connection. The **Licensed Utilization Review Sr.** is responsible for working...Current active unrestricted license or certification as a LPN, LVN , or RN to practice as a health professional… more
- Veterans Affairs, Veterans Health Administration (Eureka, CA)
- …Coordinator for questions/assistance. Learn more Duties and responsibilities of the LVN /LPN include: Incumbent performs retrospective medical review of non-VA ... Summary The Licensed Vocational Nurse/Practical Nurse ( LVN /LPN) have a broad degree of practical nursing...the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible… more
- Tenet Healthcare (Detroit, MI)
- …to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and right to ... national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition Management… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This vacancy will remain open until ... The primary purpose of the Licensed Practical/License Vocational Nurse (LPN/ LVN ) 6 is to perform assigned duties in a...understanding of the long sheet and importance of daily utilization of the form; Working knowledge of shower/tub room… 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
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