Are you an experienced Utilization Management Nurse/LVN looking for a new, REMOTE opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Daily Responsibilities of an Utilization Management Nurse/LVN:

• Doing daily clinical reviews while patient is in the hospital/SNF, transferring member to an in network hospital from an out of network ER/hospital

• Must have a clear & active LVN CA State license
• 2+ years with Telephonic Utilization Review/Management, concurrent review experience from Acute Care/Inpatient/Hospital Stay Setting (Not Payor Side)
• Experience with an MSO, Health Plan or Delegated Risk arrangement.
• Understanding of regulatory requirements such as Medicare, Medi-Cal and Commercial/DMHC
• Must be computer Savvy- Microsoft Office, strong skills with Excel
• Can handle the job under pressure and able to work in a fast paced and regulated environment
• Experience using Milliman or InterQual
• EZ Cap 6- Big Plus

• Monday-Sunday, alternating schedules between nurses for their afterhours line: Must be comfortable working on either shift, so 830-5pm/ 430pm-1am/1230am-9am (8hrs/day,40hrs/week, 2days off)

• Competitive pay between $35 to $42 per hour, paid weekly!
• REMOTE work
• Benefits offered, Medical, Dental, and Vision
• Fun and positive work environment

Interested in being considered as Utilization Management Nurse/LVN:
If you are interested in applying to this position, please click Apply Now or immediate consideration or you may send your updated resume to Kershe Esguerra at kesguerra@healthcaresupport.com.

Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.