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Utilization Mgmt Clinical Lvn Jobs

Utilization Mgmt Nurse Rev Cycle-Remote
By Advocate Aurora Health At , Oak Brook, 60523

Utilization Management Registered Nurse The ideal candidate will have a BSN and a background in Utilization Review Be able to do 25-28 reviews a day for 9 of the Advocate Aurora hospitals. Strong ...

Health Services - Coordinator, Utilization Mgmt I
By Ampcus Inc At United States
Knowledge, Skills and Abilities (KSAs)
Two years’ experience in health care/managed care setting or previous work experience within division
·Knowledge of basic medical terminology and concepts used in managed care., Proficient
accommodations may be made to enable individuals with disabilities to perform the essential functions.
Knowledge of CPT and ICD-10 coding.
·Excellent communication, organizational and customer service skills. , Proficient
Mgr Utilization Mgmt Jobs
By Texas Children's Hospital At , Houston, 77001, Tx
5 years' experience in clinical and/or managed care required
Oversee and develop the processes and procedures for Utilization Management unit of the health plan
Assess trends for future opportunity for improvement in utilization management
5 years' experience in pediatrics preferred
Bachelor's degree in nursing required
RN license from the Texas Board of Nursing or the Nursing Licensure Compact required
Utilization Mgmt Nurse Jobs
By University of Rochester At , Rochester, Ny
Full Time 40 hours Grade 044 Utilization Management
RN with Utilization Review experience preferred; 3-5 years of recent acute hospital experience preferred.
8 AM-4:30 PM; WKNDS AS NEEDED
All applicants must apply online.
Utilization Management Lvn Nurse
By Conifer Value At , Frisco, Tx
Experience working in a health plan medical management documentation system a plus
Identifies and refers members to the appropriate healthcare program (e.g. case management, disease management).
All other job-related duties as it relates to the job function or as delegated by management.
2 years managed care experience in UM/CM Department, preferred
Include minimum education, technical training, and/or experience preferred to perform the job.
Proper identification of eligibility and health plan benefits
Clinical Services Auditor (Lvn/ Lpn): Travel Required In Southern California
By Molina Healthcare At , San Diego, Ca $21.82 - $42.55 an hour

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees:

Ambulatory Clinical Supervisor - Lvn
By Martin Luther King, Jr. Community Hospital At , Los Angeles, 90059, Ca $71,885 - $104,229 a year
Minimum 2 years of supervisory or management experience in a health care setting required
Assists in managing and resolving human resource, labor relations, employee and department safety, and risk management issues.
Participate in management or leadership meetings as directed or requested.
Ensures staff provide highest quality of care which complies with the California Board of Vocational Nursing, TJC, federal/state/local requirements.
Minimum of 2 years of clinical nursing experience within the last 5 years required, ambulatory outpatient clinic experience preferred.
Has excellent observation, verbal and written communication skills.
Lvn Utilization Management Compliance
By UnitedHealth Group At , El Segundo, 90245, Ca $18.80 - $36.78 an hour
Participates in educational programs to enhance care management (UM and CM) compliance knowledge
2+ years of care management, utilization review (prior authorization) or discharge planning experience
LVN Utilization Management Compliance (Remote)
Leverages knowledge of clinical services regulatory and delegation requirements to represent Optum Clinical Services appropriately while managing delegation oversight audits
Serves as a liaison between Health Plan delegated entities and Clinical Services Operational teams (Utilization Management and Case Management)
Experience in an HMO or experience in a Managed Care setting
Cigna Medicare Clinical Operations Lpn/Lvn Case Management Analyst - Precertification-
By Cigna At , Nashville, 37214, Tn

Manager will provide If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds ...

Materials Mgmt-Shipping/Recieving Jobs
By Ignite Fueling Innovation At , Kennedy Space Center, 32815, Fl
Create and maintain accurate records of hardware within various inventory management systems
Communicate with procurement agents and property management to assist in resolving all documentation discrepancies
Perform kitting of parts for on-going projects/repairs to satisfy work order requirements
Strong data gathering and analytical skills
Excellent verbal and written communication and customer interface abilities
Provide receiving inspection of all inbound hardware supporting the ISS program
Supervisor, Um Clinical, Lvn - 4/10 Weekend Shift (Remote)
By Inland Empire Health Plans At , Rancho Cucamonga, 91730, Ca

Position Summary/Position Under the direction of the Manager, UM Clinical - Prior Authorization, the Utilization Management Clinical Supervisor, LVN is responsible for assisting in the management of ...

Utilization Management Delegation Auditor (Lvn)- Remote
By Kelsey-Seybold Clinic At , Pearland, Tx $68,827 - $85,030 a year
Job Title: Utilization Management Delegation Auditor (LVN)
Required: Knowledge of state and federal Utilization review agent requirements and regulatory compliance requirements (CMS and TDI).
Ability to effectively present information and respond to questions from peers and management.
Utilization Review experience at a health plan or medical group
Healthcare claims payment experience or healthcare billing office Experience
Employee Reward and Recognition Program
Lvn, Utilization Management - Remote
By UnitedHealth Group At , Costa Mesa, 92627, Ca $18.80 - $36.78 an hour
3+ years of managed care utilization and management experience
Composes denial letter in a manner consistent with federal regulations, state regulations, health plan requirements and NCQA standards
1+ years of experience as an UM nurse reviewer
1+ years of clinical experience
1+ years of experience processing denials
LVN, Central Denial Unit (Remote/8am to 5pm PST)
Lvn, Care Advisor, Utilization Management
By Evolent Health At , Remote $25 an hour
Minimum of one year of experience with medical management activities in a managed care/ UM review environment
Identifies and refers quality issues to the Senior Director of Medical Management, or designee.
Identifies potential cases for Care Management programs.
Collaborates with Claims, Quality Management and Provider Relations Departments as requested.
Knowledge of managed care principles, HMO and Risk Contracting arrangements.
LVN, Care Advisor, Utilization Management
Utilization Mangement Clinical Consultant (Kentucky)
By CVS Health At , Bowling Green, Ky $58,760 - $125,840 a year
3+ years clinical practice experience, e.g., hospital or behavioral health setting,
Experience with foster care population
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Utilization Management Dept Trainer Lvn – Remote
By Kelsey-Seybold Clinic At , Pearland, Tx $63,107 - $77,938 a year
Utilization Management Dept Trainer LVN – KCA Utilization Management
Required: Licensed Vocational Nurse; CEU requirement
Required: Demonstrates verbal and written communication skills. Excellent organizational, presentation, analytical, problem solving, and facilitation skills
Required: Extensive working knowledge of Microsoft Office Products
Employee Reward and Recognition Program
Paid time off for vacation, sick, and holidays

Are you looking for a challenging and rewarding role as a Clinical LVN? We are seeking an experienced professional to join our team and help us provide top-notch utilization management services to our patients. As a Clinical LVN, you will be responsible for assessing patient needs, developing treatment plans, and monitoring patient progress. You will also be responsible for ensuring that all utilization management activities are conducted in accordance with applicable laws and regulations. If you are an experienced LVN with a passion for providing quality care, then this is the job for you!

Overview:

Utilization Management Clinical LVN is a professional who is responsible for the utilization management of health care services. This includes assessing the appropriateness of services, determining the most cost-effective services, and ensuring that services are provided in a timely and efficient manner.

Detailed Job Description:

Utilization Management Clinical LVN is responsible for the utilization management of health care services. This includes assessing the appropriateness of services, determining the most cost-effective services, and ensuring that services are provided in a timely and efficient manner. The Utilization Management Clinical LVN will also be responsible for coordinating care with other providers, developing and implementing utilization management plans, and providing education and support to providers and patients.

What is Utilization Mgmt Clinical Lvn Job Skills Required?

• Knowledge of health care services and utilization management
• Ability to assess appropriateness of services
• Ability to develop and implement utilization management plans
• Excellent communication and interpersonal skills
• Ability to coordinate care with other providers
• Ability to provide education and support to providers and patients
• Knowledge of medical terminology
• Knowledge of health care regulations and standards

What is Utilization Mgmt Clinical Lvn Job Qualifications?

• Licensed Vocational Nurse (LVN)
• Bachelor’s degree in Nursing or related field
• At least two years of experience in utilization management
• Knowledge of health care services and utilization management
• Knowledge of medical terminology
• Knowledge of health care regulations and standards

What is Utilization Mgmt Clinical Lvn Job Knowledge?

• Knowledge of health care services and utilization management
• Knowledge of medical terminology
• Knowledge of health care regulations and standards

What is Utilization Mgmt Clinical Lvn Job Experience?

• At least two years of experience in utilization management

What is Utilization Mgmt Clinical Lvn Job Responsibilities?

• Assess appropriateness of services
• Develop and implement utilization management plans
• Coordinate care with other providers
• Provide education and support to providers and patients
• Monitor utilization of services
• Ensure services are provided in a timely and efficient manner
• Monitor and report on utilization trends
• Ensure compliance with health care regulations and standards