- Dignity Health (Rancho Cordova, CA)
- …is work from home within the Greater Sacramento, CA region.** **Position Summary:** The Utilization Review (UR) LVN uses clinical judgement in providing ... outcomes of patients. **Job Requirements** **Minimum Qualifications:** - 3 years Managed Care/ Utilization Management (UM) experience. - 5 years LVN experience. -… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Molina Healthcare (Long Beach, CA)
- …**Required Experience** Minimum three years clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review . **Required ... implementation of proactive approaches to improve and standardize overall retrospective claims review . * Ensures core system is updated correctly to process claim..… more
- Banner Health (Susanville, CA)
- …management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission process ... general surgeries and orthopedics. **As a Licensed Vocational Nurse, LVN , at Banner Lassen Health Center, you will perform...assessments, prepping patients for the provider and more. This LVN is a full time Monday - Friday with… 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 ... Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric...Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to… 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 defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for physician … more
- Sharp HealthCare (Chula Vista, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours**… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …education necessary to meet licensure requirements. One year experience in Utilization Review or Case Management discharge planning, current knowledge/use ... plays a vital role within the Case Management Department. The LVN within the Utilization Management team collaborates closely with Case Managers, support staff,… more
- Ventura County (Ventura, CA)
- …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities ... as a licensed Psychiatric Technician or Licensed Vocational Nurse ( LVN ) in the state of California. This is an...such as utilization review , monitoring and evaluation procedures, and… more
- ICW Group (San Diego, CA)
- …regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and ... Providers. + May perform Utilization Review activities (or review ...Current unrestricted Registered Nurse (RN) or Licensed Vocational Nurse ( LVN ) required. Certification in case management, rehabilitation nursing or… more