Lvn - Quality Assurance/utilization Review - Business Development - Full Time 8hr

Emanatehealth

Base: $31.03 - $46.54; bonus/equity: not specified...
Not specified
Current california lvn license required
Three years utilization management experience
Computer proficiency and customer service skills
Emanate Health is seeking a Licensed Vocational Nurse (LVN) for a full-time position in Quality Assurance/Utilization Review within its Business Development team. The role involves evaluating medical records for medical necessity and supporting medical claims and utilization practices

Job Summary

  • The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying clinical acumen and appropriate policies.
  • Emanate Health was named the #1 ranked health care system in the United States on Glassdoor's list of Best Places to Work in 2021.
  • The role involves documenting decisions using protocol sets, reviewing medical claims, and referring cases to Medical Directors when necessary.

Matching Summary

Match Score: 85

Emanate Health is seeking a Licensed Vocational Nurse (LVN) for a full-time position in Quality Assurance/Utilization Review within its Business Development team. The role involves evaluating medical records for medical necessity and supporting medical claims and utilization practices.

Salary

Base: $31.03 - $46.54; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Current California LVN license required
  • Three years utilization management experience
  • Computer proficiency and customer service skills

Nice-to-have

  • Experience in quality-related job preferred
  • Clinical acumen for urgent reviews
  • Ability to work as part of a team

Key Requirements

  • Minimum of three years utilization management experience
  • Current California LVN license
  • Computer proficiency required

Work Rights

Not specified

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