- US Tech Solutions, Inc. (Columbia, SC)
- …. Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits ... the state of hired, OR, active compact multistate unrestricted LPN license as defined by the Nurse ...Social Work, OR, Graduate of an Accredited School of Licensed Practical Nursing or Licensed … more
- Molina Healthcare (NV)
- … Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse ( LPN ) with experience in lieu of RN license. ... do not live in Nevada will need to be licensed for Nevada and must support Nevada (Pacific) business...this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years… more
- Molina Healthcare (Lexington, KY)
- … Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse ( LPN ) with experience in lieu of RN license. ... years in one or more of the following areas: utilization management , case management , care... platforms required; Pega UM preferred (5+yrs) + Registered Nurse , Informatics + 3+ years supervisory/ management experience… more
- CareFirst (Baltimore, MD)
- … Nurse - State Licensure And/or Compact State Licensure OR LPN - Licensed Practical Nurse - State Licensure Salary Range: $77,544 - $159,935 **Travel ... **Resp & Qualifications** **PURPOSE:** Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
- Molina Healthcare (Seattle, WA)
- …following: + Completion of an accredited Licensed Vocational Nurse (LVN) + Licensed Practical Nurse ( LPN ) Program + Bachelor's or master's degree ... the adult behavioral health system in Washington State and** ** Utilization Management experience is highly preferred.** **_Further...LPN license in good standing. + Otherwise, If licensed , license must be active, unrestricted and in good… more
- Guthrie (Sayre, PA)
- …but strong needs for clinical knowledge to leverage payors. Position Summary: The Utilization Management (UM) Reviewer, in collaboration with other internal and ... payors, and providers and staff, is responsible for the coordinates Utilization Management (UM) processes and requirements for prior authorization/certification… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
- Monte Nido (Miami, FL)
- …Medicare medical necessity criteria; consult with Admissions staff and Director of Utilization Management on all evaluations for Medicare members including level ... providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote** **Monte Nido has been delivering… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification performing risk-identification, ... Negotiates rates with non-partner providers, where applicable. Ensures appropriate access and utilization of a full continuum of network and community resources to… more
- Elevance Health (Norfolk, VA)
- ** Licensed Utilization Review II** **Location** : KS, FL. and VA. This is a remote position The ideal candidate will live within 50 miles Elevance Health ... locations. **Hours** **: Monday through Friday,10:30 - 7:00 Eastern time** The ** Licensed Utilization Review II** responsible for working primarily with… more
- CDPHP (Albany, NY)
- …years of acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization Management experience is preferred. ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...and procedures. QUALIFICATIONS + Registered Nurse or Licensed Practical Nurse with a… more
- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Nurse Utilization Management (UM) Reviewer is responsible for ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...+ In the state applicable to the member's services, LPN with Certificate and active nursing license in good… more
- Elevance Health (Tampa, FL)
- ** Licensed Utilization Review Senior** _Location:_ While remote, candidate should reside within 50 miles of either Tampa or Miami, FL. The ** Licensed ... may be involved in process improvement initiatives within the utilization management function. Examples of such functions...regulatory requirements and standards. **Minimum Requirements:** + Requires a LPN , LVN, or RN and minimum of 2 years… more
- Matrix Providers (Jacksonville, FL)
- Licensed Practical Nurse ( LPN /LVN) -Naval Hospital Jacksonville, FL Location: Jacksonville, FL, United States Healthcare Provider Type : Nursing START ... Come home to Matrix. Matrix Providers is hiring a Licensed Practical Nurse ( LPN...coordinating with the local Medical Home Port (MHP) clinic, utilization and Referral Management policies, and obtains… more
- Baystate Health (Springfield, MA)
- …+ Monday - Friday + No weekends no holidays **LOCATION** : + Springfield, MA The Licensed Practical Nurse ( LPN ) functions under the supervision and ... **Position** Licensed Practical Nurse **SCHEDULE:**... utilization management needs. The Clinical Utilization Reviewer - LPN is responsible for facilitating… more
- Brockton Hospital (Brockton, MA)
- Licensed Practical Nurse ( LPN ) Job Signature Healthcare's Urgent Care is hiring for a Licensed Practical Nurse ( LPN ) in Brockton, MA. ... Flex Shift: Varied Shift Details: M-F 7a-7p, S-Su 8a-4p Licensed Practical Nurse ( LPN...area to the examination room. Assist with the ongoing management of patient flow by prioritizing based on patient… more
- WellSpan Health (Lancaster, PA)
- Licensed Practical Nurse ( LPN ) -...of patient care between visits. + Assists in the management of patient utilization of health care ... Certificate of completion (degree or diploma) from an accredited LPN program. Required or + Associates Degree Certificate of...+ 1 year Clinical nursing experience. Required Licenses: + Licensed Practical Nurse Upon Hire… more
- STG International (Milledgeville, GA)
- …Registered Nurse (RN) is on duty at least 8 hours a day/7 day a week and a Licensed Practical Nurse ( LPN ) or Licensed Vocational Nurse (LVN) ... and education for self-help as appropriate. + Provide pain management for residents in accordance with established pain ...or university, or be a graduate of an approved Licensed Practical Nurse ( LPN… more
- Geisinger (Danville, PA)
- Job Summary Geisinger is proud to offer a full time Inpatient Licensed Practical Nurse ( LPN ) a $10,000 sign on bonus for eligible candidates as well as ... shifts! Job Duties Are you a soon to graduate LPN or newly licensed LPN ...License(s) Basic Life Support Certification - Default Issuing Body; Licensed Practical Nurse - Default… more
- Geisinger (Danville, PA)
- Job Summary Geisinger is proud to offer a per diem Inpatient Licensed Practical Nurse ( LPN ) market leading pay rates, up to $5 shift differentials for ... Graduate from Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Practical Nurse - Default Issuing Body… more
