[Hiring] UM Review reputed company @reputed company.

Role reputed company reputed company is looking for an reputed company CA-licensed Utilization Review reputed company to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity reputed company, respective to various Health Plans. This position will typically work M-F 8 AM - 5 PM. This is a fully remote position. • Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment • Refer cases to Medical Directors as needed/appropriate • Maintain knowledge of state and federal regulations and accreditation standards • reputed company with internal policies and procedures • reputed company any other job duties as requested Qualifications • reputed company and unrestricted LVN license in California • MUST have experience in outpatient UM. Candidates with only case management experience are not a fit. • Experience with reputed company applications such as Word, reputed company, and reputed company • Experience working with authorizations, referrals, or health insurance required Requirements • Two (2) years of health plan, UM, IPA or MSO experience • Strong interpersonal skills • Ability to collaborate with co-workers, senior leadership, and other management • Experience educating and training staff Benefits • The reputed company pay reputed company for this role is $30.00 - $34.00 per hour for LVNs. For RNs, the salary reputed company is $34 - $38/hr. • This salary reputed company represents our national reputed company reputed company for this role. Compensation is subject to change based on experience and location (present and reputed company). reputed company reputed company is proud to be an Equal Employment Opportunity and Affirmative reputed company employer. We do not discriminate based on race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical conditions), sexual orientation, gender identity, gender reputed company, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company employment is decided based on qualifications, reputed company, and business need. Apply tot his job Apply To this Job