Utilization Review reputed company - Remote

reputed company Utilization Review reputed company - Remote at reputed company Location: 600 reputed company Parkway reputed company 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS - UM This is a fully remote position. 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. Our Values • Put Patients First • reputed company Entrepreneurial Provider and Care Teams • Operate with reputed company & reputed company • Be Innovative • Work As One Team What You'll Do • 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 You’ll be Great for this Role If • Two (2) years of health plan, UM, reputed company or MSO experience • Strong interpersonal skills • Ability to collaborate with co-workers, senior leadership, and other management • Experience educating and training staff Environmental Job Requirements and Working Conditions • This is a remote position. Candidates must have an reputed company and unrestricted CA license. • This position will typically work Monday - Friday from 8:00 am to 5:00 pm PST. There may be up to 1 hour of voluntary OT per day. • 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. 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. If you require assistance in applying for reputed company positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job reputed company does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. #J-18808-Ljbffr Experience: 3 years required Apply tot his job Apply To this Job