- Integra Partners (Troy, MI)
- …educator to join our Operations Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management ( UM ) processes. The ... and facilitation of the Operations training and development program. The Operations UM Training Specialist will work in collaboration with Operations leadership and… more
- Molina Healthcare (Seattle, WA)
- …Any of the following: + Completion of an accredited Licensed Vocational Nurse ( LVN ) + Licensed Practical Nurse (LPN) Program + Bachelor's or master's degree in ... **Required License, Certification, Association** + If required by applicable State, an LVN /LPN license in good standing. + Otherwise, If licensed, license must be… more
- LA Care Health Plan (Los Angeles, CA)
- …UM or CM. Licenses/Certifications Required Licensed Vocational Nurse ( LVN ) - Active, current and unrestricted California License Licenses/Certifications Preferred ... Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management...and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for… more
- Scripps Health (San Diego, CA)
- …an accredited LVN or RN Program *Preferred Qualifications:* * Previous UM , QI, Discharge Planning, or Case Management experience is preferred. **Job:** **Pt Care ... necessity, benefit determination, and eligibility. *Required Qualifications:* * Current California LVN license * Three years recent clinical experience in a variety… more
- Molina Healthcare (Riverside, CA)
- For this position we are seeking a LVN (Licensed Vocational Nurse) with experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge ... teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other...of an accredited Registered Nurse (RN), Licensed Vocational Nurse ( LVN ) or Licensed Practical Nurse (LPN) Program OR a… more
- HCA Healthcare (Campbell, CA)
- …dollars to charitable organizations. Apply Today! **Job Summary and Qualifications** The UM Nurse's primary function is to ensure timely review of referral requests, ... review, following regulatory guidelines, maintaining performance standards and keeping the UM Manager informed of member/provider issues. **What you will do:** .… more
- LA Care Health Plan (Los Angeles, CA)
- …and must adhere to regulatory mandates that apply to Utilization Management ( UM ) and Care Management (CM). Collaborate with Skilled Nursing Facilities (SNF), ... physical health, behavioral health, social services, and MLTSS. Responsible for UM authorization functions for services requiring prior auths. Provides direction to… more