- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Review Specialist ( LVN ) is responsible for conducting medical reviews, benefit verification, and applying criteria to ... services requiring authorization prior to services being rendered for members. The Utilization Review Specialist ( LVN ) serves as a liaison in reviewing… more
- Scripps Health (San Diego, CA)
- …experience is preferred. **Job:** **Pt Care Technical* **Organization:** **Scripps Health Corp* **Title:** * LVN - Utilization Review - Remote within San ... 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
- 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
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve… 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 ... Certification - Various-Employee provides certificate; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians;… more
- Molina Healthcare (Riverside, CA)
- …seeking a LVN (Licensed Vocational Nurse) with experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual ... following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse ( LVN ) or Licensed Practical Nurse (LPN) Program OR a bachelor's or master's… 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
- 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 **Hours**… 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
- Hospice Of San Joaquin (Stockton, CA)
- …including the Hospice of San Joaquin Compliance manual. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW : Ensures compliance with the program plan, assuring ... we do. We are seeking a Dynamic skilled, self-motivated LVN Nurse - PM Shift who thrives in a... of resources. + Participates in Quality Assessment/Improvement and Utilization Review activities as requested by the… 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 ... Duties as assigned. **Experience:** * Current Licensure as a LPN/ LVN or RN, in the state of Texas in...years recent experience in an acute-care environment, case-management or utilization management position (experience can be a combination of… 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 ... + Documents patient case information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly case conferences by… more
- Cedars-Sinai (Culver City, CA)
- …clinical functions of the medical practice(s). 2. Assists in the development, review , and revision of standard operating policies and procedures in collaboration ... liaison, for administrative support activities including facilities management, pharmacy, utilization management, quality management, risk management, human resources, payroll,… more
- The Cigna Group (El Paso, TX)
- …ability . Typing and computer knowledge- able to type 35WPM . Knowledge of utilization review requirements and procedures . Knowledge of current health care ... of care is maintained. Provides clinical assessments, health education, and utilization management to customers. Performs community visits or telephonic outreach to… more
- CVS Health (Atlanta, GA)
- …advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and ... required compliance driven timelines. Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department Utilization … 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
- 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
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