- Prime Healthcare (Ontario, CA)
- …credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/176615/ utilization - review - nurse - lvn ... Self-Funded Plan. Qualifications Required qualifications: + Possess an active CA Licensed Vocational Nurse ( LVN ) license. + Minimum two years of experience in… 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)
- … Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/ LVN ) - Utilization Review in Bethesda, Maryland to provide care to Active ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/ LVN ) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties in… more
- Sharp HealthCare (San Diego, CA)
- …Day **FTE** 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians ... and authorizes medical services that meet medical criteria. The review of care is region specific and consists of...hospital, SNF, medical clinic etc.) + California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational… 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 ... to Matrix. Matrix Providers is hiring a Licensed Practical Nurse (LPN/ LVN ) to join our team of...coordinating with the local Medical Home Port (MHP) clinic, utilization and Referral Management policies, and obtains additional clinical… more
- STG International (Macon, GA)
- …a day/7 day a week and a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse ( LVN ) is on duty 24 hours a day. + Ensure that services provided or ... an accredited college or university, or be a graduate of an approved Licensed Practical Nurse (LPN)/Licensed Vocational Nurse ( LVN ) program. + Must have, as… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible...review and resolve clinical appeals and grievances. Prepares Nurse Summary for MD review and determination.… more
- Molina Healthcare (Los Angeles, CA)
- …Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable state ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… 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
- 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 ... BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational...Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to… more
- Molina Healthcare (UT)
- **_For this position we are seeking a LVN / LPN or RN Nurse with previous experience in Concurrent Review /_** **_Utilization Review / Utilization ... Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse ( LVN...social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital… more
- Banner Health (Tucson, AZ)
- …management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission process ... a pediatric fast track with a mid-level provider and nurse . We have Child Life services available Monday- Friday...MINIMUM QUALIFICATIONS Must possess a current, valid LPN or LVN license in state of practice, temporary LPN or… 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 ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational...Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to… more
- Sharp HealthCare (San Diego, CA)
- …0-2 errors; Have the ability to proof work. Knowledge of insurance, utilization review , scheduling requirements and front desk responsibilities. Knowledgeable on ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational...Flexible in scheduling to meet patient's needs. Completes chart review and pre-visit planning tasks daily. Offers information and… more
- The Cigna Group (Birmingham, AL)
- …skills * Typing and computer knowledge- able to type 35WPM * Knowledge of utilization review requirements and procedures * Knowledge of current health care ... Fayette County **Experience:** * Current Licensure as a Registered Nurse or LVN /LPN, in the state of...years recent experience in an acute-care environment, case-management or utilization management position (experience can be a combination of… more
- Cedars-Sinai (Culver City, CA)
- …assessments, and a variety of medically related tasks. The Supervisor is a licensed nurse who works in an administrative role in an ambulatory care setting and ... clinical functions of the medical practice(s). 2. Assists in the development, review , and revision of standard operating policies and procedures in collaboration… 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
- Sutter Health (Concord, CA)
- …of practice Fiscal Responsibility (includes productivity, HHRG rating, supply management, utilization review ) * Demonstrates ability to prioritize individual ... of an accredited school of Vocational Nursing. **CERTIFICATION & LICENSURE** LVN -Licensed Vocational Nurse BLS-Basic Life Support Healthcare Provider… more
- The Cigna Group (Bloomfield, CT)
- …required **Qualifications:** + Current Licensed Practical Nurse LPN or Licensed Vocational Nurse LVN . + Active unrestricted license in state where you reside ... Responsibilities:** + Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient… more
- Adecco US, Inc. (Minneapolis, MN)
- …LVN /LPN license in State of Residence * 2+ years of care management, utilization review (prior authorization) or discharge planning experience **Why work for ... Adecco Healthcare & Life Sciences is hiring for a ** Utilization Management** **LPN** to work **remotely** ! This is...**Location:** Remote / work from home **Responsibilities of the Utilization Management LPN:** * In collaboration with the Manager… more