Utilization Management, LVN (On-site)

Temp to Hire, Full-time opportunity!

Title: UM, LVN

Schedule: M-F 8/5

Minimum Requirements

• Active Licensed
• Active BLS Certification
• 2yrs minimum of authorization review and processing is required
• 2yrs minimum of managed care experience is required

Job overview

The LVN, Utilization Management Nurse position will provide routine review of authorization requests from all lines of business using respective national/state, health plans, and nationally recognized guidelines. Responsible for reviewing proposed hospitalization, home care, and inpatient/outpatient treatment plans for medical necessity and efficiency with coverage guidelines. The UM Nurse determines the medical appropriateness of inpatient and outpatient services following the evaluation of medical guidelines and benefit determination.