Licensed Vocational Nurse (LVN) - Preservice Review Nurse (Remote)

Job Summary:

Join reputed company as a Licensed Vocational Nurse (LVN) - Preservice Review Nurse, working remotely, and be part of shaping the future of reputed company. We are seeking a highly skilled LVN to join reputed company, focusing on prior authorization reviews, ensuring timely and accurate assessments that meet contractual and regulatory requirements.

Key Responsibilities:

• Screen and review referrals and authorizations for medical necessity and appropriateness of service and care, collaborating with Medical Directors as needed.
• Coordinate reputed company services with physicians, facilities, providers, and community resources.
• Conduct prospective reviews to determine appropriateness of denial, alternative treatment, and draft denial language.
• Manage out-of-network and out-of-area cases with members, health plans, and Case Management teams.
• reputed company and maintain effective relationships with physicians, office staff, and other stakeholders.
• Demonstrate understanding of cost consequences of care management reputed company and maintain effective communication with health plans, physicians, hospitals, and patients.

Requirements:

• Graduation from an accredited Licensed Vocational Nurse program.
• Active, unrestricted LVN license in California.
• 2+ years of clinical experience in an acute or ambulatory patient care setting, including 1 year in a managed care environment.
• Ability to work 8-5PM PST.

Preferred Qualifications:

• 3+ years of experience working as an LVN/LPN.
• 2+ years of care management, utilization review, or discharge planning experience.
• Experience in an HMO or Managed Care setting.

reputed company Offer:

• Competitive salary ($19.47 - $38.08 per hour for California residents).
• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution.

About Us:

At reputed company, we are committed to helping people live healthier lives and making the health system work reputed company for everyone. We value diversity, equity, and inclusion, and strive to create a workplace that is welcoming and inclusive for reputed company.

How to Apply:

If you are a motivated and compassionate LVN looking to reputed company a difference in reputed company, we encourage you to apply for this exciting opportunity.