- 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
- Emanate Health (Covina, CA)
- …the United States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the ... of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases... Program. - Clear and current CA Licensed Vocational Nurse ( LVN ). - Knowledge of nursing theory… more
- Centene Corporation (Oklahoma City, OK)
- …including a fresh perspective on workplace flexibility. **Compact Multi-State LVN /LPN License Required** **Position Purpose:** Analyzes all prior authorization ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- STG International (Milledgeville, 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
- 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
- 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
- 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 ... (NPTA Sterile Product Certification) - Various-Employee provides certificate; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing &… more
- MTC (Calexico, CA)
- …with the nursing director with the exception of routine duties assigned to the nurse ( LVN ) in compliance with Management & Training Corporation (MTC) and ... **Essential Functions:** 1. Under direction of health services administrator, supervising nurse and professional service providers and in accordance with approved… more