Utilization Management Nurse (LVN) Job at Healthcare Support, Remote

NzdkT0dCb3JEZXNlZXNuNVhWY2wvdz09

Job Description

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
Requirements for Utilization Management Nurse/LVN :
  • 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

Hours for this Position:
  • 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)

Advantages of this Utilization Management Nurse/LVN position:
  • 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.

Similar Jobs

Randstad General Staffing

Assembler Job at Randstad General Staffing

Join an evolving technology company as a Mechanical Assembler- Building Motor and Electrical Control Box Assemblies using hoists, hand, and power tools.

World Wide Technology Holding, LLC

Software Architect Job at World Wide Technology Holding, LLC

At least 3 years selling, architecting, implementing, and/or marketing Azure cloud solutions. Working knowledge or expertise in Azure cloud design and

Talentrupt

Inventory Control Job at Talentrupt

Job Description This position is a functional role that includes material handling and inventory control tasks to ensure all inventory is maintained accurately, and provided to required areas in a

Compliance Solutions Strategies

Executive Assistant Job at Compliance Solutions Strategies

Pittsburgh Remote [FG1] Why Confluence? Over the past several years we have undergone a great deal of positive change and growth to become the company we are today. Our global footprint now

ABMIndustries

Aircraft Cabin Agent (FT) Job at ABMIndustries

Short Description for Internal Candidates: Hourly Salary: $16.00 With a $500 Incentive. (Conditions apply) Shift: Part-Time 9 pm - 1 am Employee Discounts. Please check the entire